Individual provider Active NPI

Elliott Birkman, CPSW

  • Community/Behavioral Health Agency
  • Las Cruces, NM
National Provider Identifier
1336719467
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
1160 Issued in NM
Practice address
303 N Alameda Blvd
Las Cruces, NM 88005-2590
Phone
(575) 523-0111
NPI assigned
Jun 30, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 1160 NM Primary

Addresses

Primary practice location

303 N Alameda Blvd
Las Cruces, NM 88005-2590

Mailing address

303 N Alameda Blvd
Las Cruces, NM 88005-2590
Phone (575) 523-0111

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL gmail.com Health Information Exchange (HIE)

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1160NMMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Rydan Solutions Inc CurrentSince Aug 8, 2021 Accepting new patients
Rydan Solutions Inc Community/Behavioral Health PastSince Jul 4, 2021 Accepting new patients

Locations

303 N Alameda Blvd
Las Cruces, NM 88005
Phone (575) 523-0111

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1336719467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N ALAMEDA BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880052590",
            "telephone_number": "575-523-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N ALAMEDA BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880052590",
            "telephone_number": "575-523-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRKMAN",
        "first_name": "ELLIOTT",
        "credential": "CPSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NM",
            "license": "1160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "gmail.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "303 N Alameda Blvd",
            "city": "Las Cruces",
            "state": "NM",
            "country_code": "US",
            "postal_code": "880052590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.