Mindy Jitmanowan, PSY

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY1623 Issued in NM

Practice address

8300 Constitution Ave NE
BLDG D
Albuquerque, NM 87110-7613

Phone

(505) 291-2402

NPI assigned

Sep 6, 2013

Last updated

May 20, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Clinical Psychologist

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021

Merit-based Incentive Payment System (MIPS)

Final score

88.68 of 100Reported as group

Quality

82.35

Promoting interoperability

100

Improvement activities

40

Cost

76.6

Medicare enrollment (NPD)

Enrolled

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Presbyterian Healthcare Services

  dba Presbyterian Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470
  Care Compare affiliation
• Presbyterian Healthcare Services

  dba Presbyterian Kaseman Psych Unit

  • Psychiatric Hospital Unit
  • Albuquerque, NM
  • NPI 1598740482
  Care Compare affiliation

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

{
    "created_epoch": "1378425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1316372501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 CONSTITUTION AVE NE",
            "address_2": "BLDG D",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871107613",
            "telephone_number": "505-291-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JITMANOWAN",
        "first_name": "MINDY",
        "name_prefix": "Dr.",
        "credential": "PSY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-06",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "PSY1623",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Clinical Psychologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.