Nambe Pueblo

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

NAMBE PUEBLO

Practice address

16A Tayeh Huu U
Pueblo of Nambe, NM 87506

Phone

(505) 455-5591

NPI assigned

Oct 5, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Ryan Martinez, LMSWNPI 1841671211

Title

Program Director

Phone

(505) 455-5591

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tewa Roots Society Other name

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ryan Martinez, LSAA

  • Addiction (Substance Use Disorder) Counselor
  • Santa Fe, NM
  • NPI 1841671211
  NPD Authorized official

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755043200000",
    "number": "1073110920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15A BAY POE",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875062731",
            "telephone_number": "505-455-5591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16A TAYEH HUU U",
            "city": "PUEBLO OF NAMBE",
            "state": "NM",
            "postal_code": "87506",
            "telephone_number": "505-455-5591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAMBE PUEBLO",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-05",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "505-455-5591",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39059839",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://tewaroots.emrbear.com/",
            "affiliation": "N",
            "endpointDescription": "Secure Electronic Health Record",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "16A Tayeh Huu U",
            "city": "Pueblo of Nambe",
            "state": "NM",
            "country_code": "US",
            "postal_code": "87506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Tewa Roots Society",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Tewa Roots Society",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; 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.