Individual provider Active NPI

Cynthia A. Ziemer, PSY.D.

  • Clinical Psychologist
  • Albuquerque, NM
National Provider Identifier
1003039074
Registry record updated Oct 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1630 Issued in NM
Practice address
301 Unser Blvd NW
Albuquerque, NM 87121-1927
Phone
(505) 925-4126
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071-006197 IL
Clinical Psychologist 103TC0700X 6301015856 MI
Clinical Psychologist 103TC0700X 561 SD
Clinical Psychologist 103TC0700X 1630 NM Primary

Addresses

Primary practice location

301 Unser Blvd NW
Albuquerque, NM 87121-1927

Mailing address

6801 Sirocco PL NW
Albuquerque, NM 87114-3201
Phone (708) 763-8158

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201106000087 NM Practitioner - Clinical Psychologist 9335394659 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071-006197ILMDClinical Psychologist
6301015856MIMDClinical Psychologist
1630NMMDClinical Psychologist
561SDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Meditelecare of New Mexico, LLC Clinical CurrentSince Oct 1, 2021 Accepting new patients

Locations

206 S Coronado Ave
Espanola, NM 87532
Phone (833) 807-8727

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602806400000",
    "number": "1003039074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 SIROCCO PL NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871143201",
            "telephone_number": "708-763-8158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNSER BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871211927",
            "telephone_number": "505-925-4126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIEMER",
        "first_name": "CYNTHIA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-10-16",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-006197",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301015856",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "SD",
            "license": "561",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "1630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.