Individual provider Active NPI

Pablo Juvencio Valerio, CNP

  • Family Nurse Practitioner
  • Sunland Park, NM
National Provider Identifier
1497358964
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
64224 Issued in NM
Practice address
2625 McNutt Rd
Sunland Park, NM 88063-9608
Phone
(575) 589-0887
Fax
(575) 589-0898
NPI assigned
Nov 18, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1018786 TX
Family Nurse Practitioner 363LF0000X 64224 NM Primary

Addresses

Primary practice location

2625 McNutt Rd
Sunland Park, NM 88063-9608

Mailing address

385 Calle de Alegra Ste a
Las Cruces, NM 88005-3423
Phone (575) 526-1105

Other identifiers 1

IdentifierTypeStateIssuer
93936524MedicaidNM

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210929002205 NM Practitioner - Nurse Practitioner 6204233588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2625 McNutt Rd
Suite B
Sunland Park, NM 88063-9608
Phone (575) 589-6540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1018786TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de Familia, Incorporated CurrentSince Aug 8, 2022 Accepting new patients
La Clinica de Familia, Incorporated CurrentSince Aug 8, 2022 Accepting new patients
La Clinica de Familia, Incorporated Current Accepting new patients

Locations

826 Anthony Dr
Anthony, NM 88021
Phone (575) 201-5135

385 Calle de Alegra
Bldg A
Las Cruces, NM 88005
Phone 57552611052444

100 Airport Rd
Santa Teresa, NM 88008
Phone (575) 874-9338

2625 McNutt Rd
Ste B
Sunland Park, NM 88063
Phone (575) 589-0887

2625 McNutt Rd
Sunland Park, NM 88063
Phone (575) 589-0887

Interoperability endpoints

  • Direct secure messaging: pablo.valerio@lcdfnm.eclinicaldirectplus.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1497358964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 CALLE DE ALEGRA STE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053423",
            "telephone_number": "575-526-1105",
            "fax_number": "575-524-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 MCNUTT RD",
            "city": "SUNLAND PARK",
            "state": "NM",
            "postal_code": "880639608",
            "telephone_number": "575-589-0887",
            "fax_number": "575-589-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALERIO",
        "first_name": "PABLO",
        "middle_name": "JUVENCIO",
        "name_prefix": "Mr.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-18",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1018786",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "64224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "93936524",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunland Park, NM

Sources for this page

Verify at the official NPI Registry.