Active NPI
Donovan Lucero
- Peer Specialist
- Laguna, NM
National Provider Identifier
1467094029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 7 Rio San Jose Dr
Laguna, NM 87026 - Phone
- (505) 552-6513
- NPI assigned
- Oct 15, 2019
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Primary |
Addresses
Primary practice location
7 Rio San Jose Dr
Laguna, NM 87026
Mailing address
7 Rio San Jose Dr
Laguna, NM 87026
Phone (505) 552-6513
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 125433189 | Medicaid | NM |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dlucero@pol-nsn.gov | Direct |
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": "1571097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571097600000",
"number": "1467094029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 RIO SAN JOSE DR",
"city": "LAGUNA",
"state": "NM",
"postal_code": "87026",
"telephone_number": "505-552-6513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 RIO SAN JOSE DR",
"city": "LAGUNA",
"state": "NM",
"postal_code": "87026",
"telephone_number": "505-552-6513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCERO",
"first_name": "DONOVAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-10-15",
"last_updated": "2019-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "125433189",
"state": "NM"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "dlucero@pol-nsn.gov",
"affiliation": "N",
"endpointDescription": "work email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "email",
"address_1": "7 Rio San Jose",
"city": "Laguna",
"state": "NM",
"country_code": "US",
"postal_code": "87026",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Laguna, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.