Individual provider Active NPI

Denise P. Marez, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Albuquerque, NM
National Provider Identifier
1295011583
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4923 Issued in NM
Practice address
9500 Montgomery Blvd NE Ste 215
Albuquerque, NM 87111-2579
Phone
(505) 247-4224
Fax
(505) 247-1772
NPI assigned
Oct 31, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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 4923 NM Primary

Addresses

Primary practice location

9500 Montgomery Blvd NE Ste 215
Albuquerque, NM 87111-2579

Mailing address

10700 Academy Rd NE Apt 1826
Albuquerque, NM 87111-7336
Phone (505) 238-8688

Other identifiers 1

IdentifierTypeStateIssuer
APPLIED FORMedicaidNM

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
4923NMMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Albuquerque Speech Language and Hearing Center 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": "1320019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1295011583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 ACADEMY RD NE APT 1826",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871117336",
            "telephone_number": "505-238-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 MONTGOMERY BLVD NE STE 215",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112579",
            "telephone_number": "505-247-4224",
            "fax_number": "505-247-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAREZ",
        "first_name": "DENISE",
        "middle_name": "P.",
        "name_prefix": "Miss",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-31",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "4923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "APPLIED FOR",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; 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.