MEDICARE: MICHAEL PATRICK MEADERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator		NM

General Provider Information

NPI Number	:	1942153556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL PATRICK MEADERS

Provider Business Mailing Address
First Line	:	2052 GALISTEO ST
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-2100
Country	:	US
Telephone Number	:	505-819-3419
Fax Number	:	505-428-9443

Provider Business Practice Location Address
First Line	:	2052 GALISTEO ST
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-2100
Country	:	US
Telephone Number	:	505-819-3419
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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