Active NPI
Pablo Juvencio Valerio, CNP
- Family Nurse Practitioner
- Sunland Park, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 64224
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 93936524 | Medicaid | NM |
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
Enrollment records 1
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1018786 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Clinica de Familia, Incorporated | Current | Accepting new patients | |
| La Clinica de Familia, Incorporated | Current | 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
- 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.
-
- Federally Qualified Health Center (FQHC)
- Las Cruces, NM
- NPI 1528424397
-
- Federally Qualified Health Center (FQHC)
- Las Cruces, NM
- NPI 1134917040
-
- Federally Qualified Health Center (FQHC)
- Las Cruces, NM
- NPI 1740286863
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.