Moses Bulambo, PMHNP-BC
Individual provider Active NPI Psychiatry Physician · Lovington, NM
NPI 1104410331 · NPPES record last updated Feb 28, 2021
Key facts
- NPI
- 1104410331
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 62667 (NM)
- Practice address
- 918 W Avenue D
Lovington, NM 88260-3808 - Phone
- (575) 425-6045
- NPI assigned
- Feb 28, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Luxe Psychiatric and Wellness Services LLC
Practice addresses (Care Compare)
313 W Country Club Rd
Suite 9
Roswell, NM 88201-5804
Phone (575) 425-6047
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210310000193 | NM | Practitioner - Nurse Practitioner | 9537575923 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 62667 | NM | Yes |
Addresses
Primary practice location
918 W Avenue D
Lovington, NM 88260-3808
Mailing address
613 W 2ND St Ste 5
Roswell, NM 88201-4671
Phone (575) 840-4888
Other providers in Lovington, NM
- Stephanie Lynn Blackwood
- Blue Sky Counseling
- Sarah Boyd
- Raegan Bromley
- Lindsey Anitra Broom
- Sharyn Bush
- Cecilia Bustamante
- Maricela Bustillos
- Brian Scott Buttyan
- Grace Caltagirone
All providers in Lovington, NM · Psychiatry Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.