Active NPI
Nick D. Abeyta, P.T.
- Physical Therapist
- Chama, NM
National Provider Identifier
1245316256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 642
- Practice address
- 612 Terrace Avenue
Chama, NM 87520-0976 - Phone
- (505) 756-4024
- NPI assigned
- Oct 31, 2006
- Last updated
- May 28, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 642 | NM | Primary |
Addresses
Primary practice location
612 Terrace Avenue
Chama, NM 87520-0976
Mailing address
PO Box 976
Chama, NM 87520-0976
Phone (505) 756-4024
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000K3526 | Medicaid | NM | |
| HSZ196 | Other | NM | MEDICARE PART B |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 642 | NM | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jicarilla IHS Pharmacy | Past | Accepting new patients | |
| Abeyta Enterprises Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pharmacist
- Chama, NM
- NPI 1679677900
-
dba Dulce IHS Pharmacy
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
- Dulce, NM
- NPI 1124220900
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211932800000",
"number": "1245316256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 976",
"city": "CHAMA",
"state": "NM",
"postal_code": "875200976",
"telephone_number": "505-756-4024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "612 TERRACE AVENUE",
"city": "CHAMA",
"state": "NM",
"postal_code": "875200976",
"telephone_number": "505-756-4024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABEYTA",
"first_name": "NICK",
"middle_name": "D.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-31",
"last_updated": "2008-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "642",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000K3526",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PART B",
"identifier": "HSZ196",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chama, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.