Individual provider Active NPI

Sanjuanita De Luna, LMSW-IPR

  • Clinical Social Worker
  • Laredo, TX
National Provider Identifier
1356649735
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
6510 Polaris Dr
Suite 2, Unit 10
Laredo, TX 78041-2053
Phone
(956) 284-0079
NPI assigned
Mar 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 19571 TX
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

6510 Polaris Dr
Suite 2, Unit 10
Laredo, TX 78041-2053

Mailing address

8642 Puerto Escondido
Laredo, TX 78045-6204
Phone (956) 220-8037

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20230303000229 TX Practitioner - Clinical Social Worker 2163895640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1515 Pappas St
Laredo, TX 78041-1705
Phone (956) 795-8100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19571TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Community Health Center, Inc CurrentSince Oct 18, 2022 Accepting new patients
Gateway Community Health Center, Inc Current Accepting new patients
Gateway Community Health Center Inc CurrentSince Oct 18, 2022 Accepting new patients

Locations

1515 Pappas St
Laredo, TX 78041
Phone (956) 523-3642

Interoperability endpoints

  • Direct secure messaging: sanjuanita.de.luna.1@29268.direct.athenahealth.com

Organizations & group practices 3

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": "1299542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1356649735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8642 PUERTO ESCONDIDO",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780456204",
            "telephone_number": "956-220-8037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6510 POLARIS DR",
            "address_2": "SUITE 2, UNIT 10",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780412053",
            "telephone_number": "956-284-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LUNA",
        "first_name": "SANJUANITA",
        "credential": "LMSW-IPR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-08",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "TX",
            "license": "19571",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.