Individual provider Active NPI

Don J. Chavez

  • Clinical Social Worker
  • Santa Fe, NM
National Provider Identifier
1417977059
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-04730 Issued in NM
Practice address
1533 S Saint Francis Dr
Suite E
Santa Fe, NM 87505-4032
Phone
(505) 988-4131
NPI assigned
Jul 19, 2006
Last updated
Jul 12, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral Counselor 101YP1600X 9585 NM
Clinical Social Worker 1041C0700X I-04730 NM Primary

Addresses

Primary practice location

1533 S Saint Francis Dr
Suite E
Santa Fe, NM 87505-4032

Mailing address

865 Camino Consuelo
Santa Fe, NM 87507-5034

Other identifiers 2

IdentifierTypeStateIssuer
9585OtherNMAAPC MEMBERSHIP #
A1366MedicaidNM

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
I20040128000097 NM Practitioner - Clinical Social Worker 4587567680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychotherapy and Pastoral Counseling AssociatesGroup PAC ID 2062780083, 8 clinicians

Practice addresses (Care Compare)

2019 Galisteo St
Suite M1A
Santa Fe, NM 87505-2110
Phone (505) 988-4131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9585NMMDPastoral Counselor
I-04730NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychotherapy & Pastoral Counseling Associates CurrentSince Jul 1, 2017 Accepting new patients

Locations

2019 Galisteo St
Ste M1A
Santa Fe, NM 87505
Phone (505) 988-4131

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, 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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1417977059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 CAMINO CONSUELO",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875075034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1533 S SAINT FRANCIS DR",
            "address_2": "SUITE E",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054032",
            "telephone_number": "505-988-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "DON",
        "middle_name": "J.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "NM",
            "license": "9585",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-04730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAPC MEMBERSHIP #",
            "identifier": "9585",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A1366",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.