Crystal J Tortalita

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

85 West Hwy 22
Santo Domingo Pueblo, NM 87052

Phone

(505) 465-3060

Fax

(505) 318-1079

NPI assigned

Apr 17, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Kewa Pueblo Health Corporation

  • Community/Behavioral Health Agency
  • Santo Domingo Pueblo, NM
  • NPI 1336659077
  NPD (past)
• Kewa Pueblo Health Corporation

  • Federally Qualified Health Center (FQHC)
  • Santo Domingo Pueblo, NM
  • NPI 1467739888
  NPD (past)

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

{
    "created_epoch": "1713312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1497509129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 340",
            "city": "SANTO DOMINGO PUEBLO",
            "state": "NM",
            "postal_code": "870520340",
            "telephone_number": "505-465-3060",
            "fax_number": "505-318-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 WEST HWY 22",
            "city": "SANTO DOMINGO PUEBLO",
            "state": "NM",
            "postal_code": "87052",
            "telephone_number": "505-465-3060",
            "fax_number": "505-318-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORTALITA",
        "first_name": "CRYSTAL",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Santo Domingo Pueblo
• Santo Domingo Tribe
• Mathew Strickland, M.D., M.P.H.
• Beth Aime Strimpel, RN
• Dezbah Stumpff, LMHC
• Soren Uhl, RN
• Janet Reyes Vega, RN
• Timothy W Watkins, LCSW
• Yu Jin Williams, RN
• Johannah Renee Yazzie, CPNP-PC

• Case Manager/Care Coordinator in Santo Domingo Pueblo, NM
• Providers in Santo Domingo Pueblo, NM by specialty
• Case Manager/Care Coordinator in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.