NPIMap

Organization Active NPI

Blooming Cactus Wellness LLC

  • Primary Care Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1477127264
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
BLOOMING CACTUS WELLNESS LLC
Practice address
7801 Academy Rd NE Ste 2-104
Albuquerque, NM 87109-3189
Phone
(505) 730-5020
Fax
(505) 212-5500
NPI assigned
May 17, 2021
Last updated
Mar 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Authorized official

Name
Pala-Nicole Rivera, CNPNPI 1831708924
Title
Owner / Director
Phone
(505) 730-5020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X Primary

Addresses

Primary practice location

7801 Academy Rd NE Ste 2-104
Albuquerque, NM 87109-3189

Mailing address

9012 Galaxia Way NE
Albuquerque, NM 87111-1441
Phone (505) 730-5020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210719001350 NM Part B Supplier - Clinic/Group Practice 5991108680 Receives reassigned benefits from 7 practitioners
Practice locations: Albuquerque, NM

National Provider Directory

National Provider Directory

Locations

7801 Academy Rd NE
Ste 2-104
Albuquerque, NM 87109
Phone (505) 730-5020

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774310400000",
    "number": "1477127264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9012 GALAXIA WAY NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871111441",
            "telephone_number": "505-730-5020",
            "fax_number": "505-387-3257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7801 ACADEMY RD NE STE 2-104",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093189",
            "telephone_number": "505-730-5020",
            "fax_number": "505-212-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMING CACTUS WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-17",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "PALA-NICOLE",
        "authorized_official_title_or_position": "OWNER / DIRECTOR",
        "authorized_official_telephone_number": "505-730-5020",
        "authorized_official_credential": "CNP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "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 Mar 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.