Kyle McKenzie Manuelito

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

1570 Issued in NM

Practice address

6000 Uptown Blvd NE Ste 140
Albuquerque, NM 87110-4157

Phone

(505) 305-4949

NPI assigned

Apr 23, 2024

Last updated

Apr 23, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Serna Solutions LLC

  • Mental Health Counselor
  • Albuquerque, NM
  • NPI 1295433985
  NPD

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

{
    "created_epoch": "1713830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1033964812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 644",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873050644",
            "telephone_number": "505-713-4456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 UPTOWN BLVD NE STE 140",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104157",
            "telephone_number": "505-305-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANUELITO",
        "first_name": "KYLE",
        "middle_name": "MCKENZIE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-23",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NM",
            "license": "1570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mansour Family Dentistry & Invisalign Inc
• Rafat M Mansour, DDS
• Akee Mansouri
• Luzia K Manuel
• Sloan Manuel
• Isabelle Manwill
• Kathleen NMN Manygoats, MSW
• David James Manzanares, D.D.S.
• Lauren Casey Manzanares
• Michael James Manzanares, D.D.S.

• Peer Specialist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Peer Specialist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.

Verify at the official NPI Registry.