Individual provider Active NPI

Maurits Willem Rol, MD

  • Psychiatry Physician
  • Corrales, NM
National Provider Identifier
1366464299
Registry record updated Sep 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
88-253 Issued in NM
Practice address
3949 Corrales Rd Ste 180
Corrales, NM 87048-9349
Phone
(505) 738-3621
NPI assigned
Jul 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 88-253 NM Primary

Addresses

Primary practice location

3949 Corrales Rd Ste 180
Corrales, NM 87048-9349

Mailing address

3949 Corrales Rd Ste 180
Corrales, NM 87048-9349
Phone (505) 738-3621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160309001043 NM Practitioner - Psychiatry 5193021665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Virginia School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

171 Tierra Encantada
Corrales, NM 87048-6811
Phone (505) 738-3621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
88-253NMMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Control Over Anxiety, LLC Psychiatry CurrentSince Jan 11, 2016 Accepting new patients

Locations

3949 Corrales Rd
Ste 180
Corrales, NM 87048
Phone (505) 433-1750

4101 Corrales Rd
Unit 1157
Corrales, NM 87048

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": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442534400000",
    "number": "1366464299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3949 CORRALES RD STE 180",
            "city": "CORRALES",
            "state": "NM",
            "postal_code": "870489349",
            "telephone_number": "505-738-3621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3949 CORRALES RD STE 180",
            "city": "CORRALES",
            "state": "NM",
            "postal_code": "870489349",
            "telephone_number": "505-738-3621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROL",
        "first_name": "MAURITS",
        "middle_name": "WILLEM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2015-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NM",
            "license": "88-253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corrales, NM

Sources for this page

Verify at the official NPI Registry.