Individual provider Active NPI

Timothy Bartosh, LMSW

  • Social Worker
  • Albuquerque, NM
National Provider Identifier
1396464772
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SWB-2024-1305 Issued in NM
Practice address
4300 San Mateo Blvd NE Ste B186
Albuquerque, NM 87110-8409
Phone
(505) 226-2839
NPI assigned
Aug 26, 2022
Last updated
Feb 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X
Social Worker 104100000X SWB-2024-1305 NM Primary

Addresses

Primary practice location

4300 San Mateo Blvd NE Ste B186
Albuquerque, NM 87110-8409

Mailing address

4300 San Mateo Blvd NE Ste B186
Albuquerque, NM 87110-8409
Phone (505) 226-2839

Other practice location 1

6330 Riverside Plaza Ln NW Ste 260
Albuquerque, NM 87120-2160
Phone (505) 226-2839

Other identifiers 1

IdentifierTypeStateIssuer
06337767MedicaidNM

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
SWB-2024-1305NMMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Trauma Treatment Center LLC PastSince Aug 1, 2022 Accepting new patients
Cottonwood Counseling, LLC PastSince Jan 12, 2025 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1396464772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 SAN MATEO BLVD NE STE B186",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871108409",
            "telephone_number": "505-226-2839",
            "fax_number": "505-295-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 SAN MATEO BLVD NE STE B186",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871108409",
            "telephone_number": "505-226-2839"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6330 Riverside Plaza Ln NW Ste 260",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871202160",
            "country_code": "US",
            "telephone_number": "505-226-2839",
            "fax_number": "505-295-2559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARTOSH",
        "first_name": "TIMOTHY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-26",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "SWB-2024-1305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06337767",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.