Individual provider Active NPI

Mario Romero

  • Behavior Analyst
  • Albuquerque, NM
National Provider Identifier
1447790795
Registry record updated Jul 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
707 Broadway Blvd NE Ste 300
Albuquerque, NM 87102
Phone
(505) 345-8471
NPI assigned
Mar 6, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

707 Broadway Blvd NE Ste 300
Albuquerque, NM 87102

Mailing address

707 Broadway Blvd NE Ste 300
Albuquerque, NM 87102-2365
Phone (505) 345-8471

Other practice location 1

700 Friedman Ave
Las Vegas, NM 87701-4231
Phone (505) 454-5137

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidNM

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": "1488758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531267200000",
    "number": "1447790795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 BROADWAY BLVD NE STE 300",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022365",
            "telephone_number": "505-345-8471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 BROADWAY BLVD NE STE 300",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87102",
            "telephone_number": "505-345-8471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Friedman Ave",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NM",
            "postal_code": "877014231",
            "country_code": "US",
            "telephone_number": "505-454-5137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMERO",
        "first_name": "MARIO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-06",
        "last_updated": "2018-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "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 Jul 11, 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.