NPIMap

Individual provider Active NPI

Manuel A Mireles, SLP

  • Speech-Language Pathologist
  • Las Cruces, NM
National Provider Identifier
1114452281
Registry record updated Apr 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
1681 Hickory Loop
Las Cruces, NM 88005-6502
Phone
(575) 647-3773
Fax
(575) 647-3777
NPI assigned
Apr 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

1681 Hickory Loop
Las Cruces, NM 88005-6502

Mailing address

301 Perkins Dr
Ste B
Las Cruces, NM 88005-3248
Phone (575) 652-3155

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aprendamos Intervention Team PA Past Accepting new patients

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": "1493164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493164800000",
    "number": "1114452281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 PERKINS DR",
            "address_2": "STE B",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053248",
            "telephone_number": "575-652-3155",
            "fax_number": "575-652-4104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1681 HICKORY LOOP",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880056502",
            "telephone_number": "575-647-3773",
            "fax_number": "575-647-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRELES",
        "first_name": "MANUEL",
        "middle_name": "A",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-26",
        "last_updated": "2017-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; 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.