Individual provider Active NPI

Joseph J Mazzuca, LMSW

  • Social Worker
  • Las Cruces, NM
National Provider Identifier
1083389332
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
X-12027 Issued in NM
Practice address
535 S. Miranda St.
Las Cruces, NM 88005
Phone
(575) 647-2800
Fax
(575) 647-2898
NPI assigned
Aug 10, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X X-12027 NM Primary

Addresses

Primary practice location

535 S. Miranda St.
Las Cruces, NM 88005

Mailing address

385 Calle de Alegra Ste a
Las Cruces, NM 88005-3423
Phone (575) 526-1105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240219003428 NM Practitioner - Clinical Social Worker 1951745835 Reassigns benefits to 1 organization
I20241024002388 MA Practitioner - Clinical Social Worker 1951745835 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X-12027NMMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de Familia, Incorporated CurrentSince Dec 8, 2023 Accepting new patients
Northeast Health Services, LLC CurrentSince Oct 1, 2024 Accepting new patients
La Clinica de Familia, Incorporated CurrentSince Dec 8, 2023 Accepting new patients
La Clinica de Familia, Incorporated Current Accepting new patients

Locations

1 Union St
Fl 3
Boston, MA 02108
Phone (617) 351-8940

30 Taunton Grn
Ste 5
Taunton, MA 02780
Phone (508) 545-7400

826 Anthony Dr
Anthony, NM 88021
Phone (575) 201-5135

385 Calle de Alegra
Bldg A
Las Cruces, NM 88005
Phone 57552611052444

760 N Motel Blvd
Ste Ac
Las Cruces, NM 88007

535 S Miranda St
Las Cruces, NM 88005

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1083389332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 CALLE DE ALEGRA STE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053423",
            "telephone_number": "575-526-1105",
            "fax_number": "575-524-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 S. MIRANDA ST.",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "88005",
            "telephone_number": "575-647-2800",
            "fax_number": "575-647-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZUCA",
        "first_name": "JOSEPH",
        "middle_name": "J",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-10",
        "last_updated": "2021-08-10",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "X-12027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.