Active NPI
Jeremy Bacoccini
- Social Worker
- Albuquerque, NM
National Provider Identifier
1396507331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 1120 2ND St NW
Albuquerque, NM 87102-2218 - Phone
- (505) 273-8750
- NPI assigned
- Jan 25, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
1120 2ND St NW
Albuquerque, NM 87102-2218
Mailing address
1120 2ND St NW
Albuquerque, NM 87102-2218
Phone (505) 273-8750
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706140800000",
"number": "1396507331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 2ND ST NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871022218",
"telephone_number": "505-273-8750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 2ND ST NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871022218",
"telephone_number": "505-273-8750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACOCCINI",
"first_name": "JEREMY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-01-25",
"last_updated": "2024-01-25",
"certification_date": "2024-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Jan 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.