Individual provider Active NPI

Marisa Raquel Esquivel, DPT

  • Orthopedic Physical Therapist
  • Albuquerque, NM
National Provider Identifier
1407376460
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
1708 Issued in NM
Practice address
9201 Montgomery Blvd NE Ste 302
Albuquerque, NM 87111-2467
Phone
(505) 293-6262
Fax
(505) 293-6622
NPI assigned
Jun 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 1708 NM Primary

Addresses

Primary practice location

9201 Montgomery Blvd NE Ste 302
Albuquerque, NM 87111-2467

Mailing address

9201 Montgomery Blvd NE Ste 302
Albuquerque, NM 87111-2467
Phone (505) 293-6262

Other identifiers 1

IdentifierTypeStateIssuer
1053470187OtherFACILITY NPI

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1407376460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 MONTGOMERY BLVD NE STE 302",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112467",
            "telephone_number": "505-293-6262",
            "fax_number": "505-293-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 MONTGOMERY BLVD NE STE 302",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871112467",
            "telephone_number": "505-293-6262",
            "fax_number": "505-293-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESQUIVEL",
        "first_name": "MARISA",
        "middle_name": "RAQUEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-21",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NM",
            "license": "1708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY NPI",
            "identifier": "1053470187",
            "state": null
        }
    ],
    "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 Nov 30, 2018; 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.