Individual provider Active NPI

Libni Simei Perez Luis, FNP-C

  • Family Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1114723491
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
58204 Issued in NM
Practice address
1648 Alameda Blvd NW
Albuquerque, NM 87114-8807
Phone
(505) 585-0085
NPI assigned
Feb 19, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 58204 NM Primary

Addresses

Primary practice location

1648 Alameda Blvd NW
Albuquerque, NM 87114-8807

Mailing address

1648 Alameda Blvd NW
Albuquerque, NM 87114-8807
Phone (505) 585-0085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260624004841 NM Practitioner - Nurse Practitioner 7517430176 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1648 Alameda Blvd NW
Albuquerque, NM 87114-8807

PO Box
Suite 67553
Albuquerque, NM 87193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
58204NMMDFamily Nurse Practitioner

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": "1739923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1114723491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1648 ALAMEDA BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871148807",
            "telephone_number": "505-585-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1648 ALAMEDA BLVD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871148807",
            "telephone_number": "505-585-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ LUIS",
        "first_name": "LIBNI",
        "middle_name": "SIMEI",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-19",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "58204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.