Individual provider Active NPI

Marisa B Nochumson, LCSW

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1376776567
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SWB-2023-0717 Issued in NM
Practice address
1401 William St SE
Albuquerque, NM 87102-4661
Phone
(505) 768-5450
Fax
(505) 842-1185
NPI assigned
Sep 3, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SWB-2023-0717 NM Primary

Addresses

Primary practice location

1401 William St SE
Albuquerque, NM 87102-4661

Mailing address

1401 William St SE
Albuquerque, NM 87102-4661
Phone (505) 768-5450

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240125002957 NM Practitioner - Clinical Social Worker 1052764032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El Pueblo Health Services, IncGroup PAC ID 9739170697, 11 clinicians

Practice addresses (Care Compare)

121 Calle del Preidente
Bernalillo, NM 87004-6091

121 Calle del Presidente
Bernalillo, NM 87004-6091
Phone (505) 867-2324

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SWB-2023-0717NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
El Pueblo Health Services, Inc CurrentSince Dec 24, 2023 Accepting new patients
El Pueblo Health Services, Inc CurrentSince Dec 24, 2023 Accepting new patients

Locations

121 Calle del Presidente
Bernalillo, NM 87004
Phone (505) 867-2324

Interoperability endpoints

  • Direct secure messaging: marisa.nochumson.1@30308.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/30308/brand/1/csg/1/fhir/r4

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": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1376776567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 WILLIAM ST SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871024661",
            "telephone_number": "505-768-5450",
            "fax_number": "505-842-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 WILLIAM ST SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871024661",
            "telephone_number": "505-768-5450",
            "fax_number": "505-842-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOCHUMSON",
        "first_name": "MARISA",
        "middle_name": "B",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-03",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2023-0717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.