OrganizationActive
San Juan Regional Medical Center Inc
NPI 1093800534 · Pediatrics Physician · Farmington, NM
Provider details
- NPI number
- 1093800534
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- San Juan Regional Medical Center Inc
- Organization subpart
- Yes
- Authorized official
- Kim Byrd, Administrative Director of Reimburs(505) 609-2258
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
407 S Schwartz Ave
Suite 102
Farmington, NM 87401-5925
Phone: (505) 609-6700
Fax: (505) 609-6701
Street-level locationGet directions
Mailing address
Po Box 844088
Dallas, TX 75284-4088
Other names (DBA / former)
- Doing business as
- San Juan Pediatrics
Registry dates
- Enumerated
- 2006-10-03
- Last updated
- 2025-07-16
- Certified
- 2025-07-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.