Active NPI
Nikka Peralta
- Clinical Social Worker
- Albuquerque, NM
National Provider Identifier
1013299593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C-09284
- Practice address
- 3939 San Pedro Dr NE BLDG B1
Albuquerque, NM 87110-8903 - Phone
- (505) 903-5437
- Fax
- (505) 344-2104
- NPI assigned
- Sep 12, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C-09284 | NM | Primary |
Addresses
Primary practice location
3939 San Pedro Dr NE BLDG B1
Albuquerque, NM 87110-8903
Mailing address
1305 San Lorenzo Ave NW
Albuquerque, NM 87107-3427
Phone (505) 903-5437
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C-09284 | NM | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mending Hearts, LLC | Clinical | Current | Accepting new patients |
Locations
3939 San Pedro Dr NE
Bldg B1
Albuquerque, NM 87110
Phone (505) 440-7600
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": "1315785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722470400000",
"number": "1013299593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1305 SAN LORENZO AVE NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871073427",
"telephone_number": "505-903-5437",
"fax_number": "505-344-2104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3939 SAN PEDRO DR NE BLDG B1",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871108903",
"telephone_number": "505-903-5437",
"fax_number": "505-344-2104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERALTA",
"first_name": "NIKKA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-12",
"last_updated": "2024-08-01",
"certification_date": "2024-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "C-09284",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.