Individual provider Active NPI

Maria Esmeralda Otame, LCSW

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1215359278
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7601-C Issued in NV
Practice address
5100 W Sahara Ave
Las Vegas, NV 89146-3406
Phone
(702) 799-2273
NPI assigned
Jan 10, 2014
Last updated
Feb 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C-09919 NM
Clinical Social Worker 1041C0700X 7601-C NV Primary

Addresses

Primary practice location

5100 W Sahara Ave
Las Vegas, NV 89146-3406

Mailing address

P.O. Drawer 70
Anthony, NM 88047-0070
Phone (575) 882-6101

Other practice location 1

2965 S Jones Blvd Ste C
Las Vegas, NV 89146-5606
Phone (702) 471-0420

Other practice location 2

1301 West Washington Street
Anthony, NM 88021-8846
Phone (575) 882-6101

Other practice location 3

6402 McLeod Dr Ste 5
Las Vegas, NV 89120-4406
Phone (725) 204-8809

Other names 1

  • Maria Esmeralda Reyes Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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 1

Enrollment IDStateProvider typePAC IDDetails
I20211018001376 NV Practitioner - Clinical Social Worker 3375941628 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C-09919NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fuente de Vida Mental Health Services Clinical CurrentSince Oct 7, 2021 Accepting new patients

Locations

2545 Chandler Ave
Ste 7
Las Vegas, NV 89120
Phone (702) 544-1638

6402 McLeod Dr
Ste 5
Las Vegas, NV 89120
Phone (702) 898-5311

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1389312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1215359278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. DRAWER 70",
            "city": "ANTHONY",
            "state": "NM",
            "postal_code": "880470070",
            "telephone_number": "575-882-6101",
            "fax_number": "575-882-6926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 W SAHARA AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891463406",
            "telephone_number": "702-799-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2965 S Jones Blvd Ste C",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891465606",
            "country_code": "US",
            "telephone_number": "702-471-0420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1301 West Washington Street",
            "address_purpose": "LOCATION",
            "city": "Anthony",
            "state": "NM",
            "postal_code": "880218846",
            "country_code": "US",
            "telephone_number": "575-882-6101",
            "fax_number": "575-882-6926",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6402 McLeod Dr Ste 5",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891204406",
            "country_code": "US",
            "telephone_number": "725-204-8809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OTAME",
        "first_name": "MARIA",
        "middle_name": "ESMERALDA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-10",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-09919",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "7601-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "REYES",
            "middle_name": "ESMERALDA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.