Individual provider Active NPI

Alex Valenzuela

  • Clinical Social Worker
  • Somerton, AZ
National Provider Identifier
1528691235
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-18495 Issued in AZ
Practice address
950 E Main St BLDG B
Somerton, AZ 85350-7409
Phone
(928) 236-8001
Fax
(928) 722-6113
NPI assigned
Feb 20, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-18495 AZ Primary

Addresses

Primary practice location

950 E Main St BLDG B
Somerton, AZ 85350-7409

Mailing address

PO Box 617
Somerton, AZ 85350-0617
Phone (928) 315-7910

Other identifiers 1

IdentifierTypeStateIssuer
003357MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200529002067 AZ Practitioner - Clinical Social Worker 1951722966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
San Luis Walk-in Clinic IncGroup PAC ID 2668361841, 49 clinicians

Practice addresses (Care Compare)

950 E Main St
BLDG B
Somerton, AZ 85350-7409
Phone (928) 236-8001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
San Luis Walk-in Clinic, Inc. Current Accepting new patients
San Luis Walk-in Clinic, Inc. Current Accepting new patients
San Luis Walk-in Clinic, Inc. CurrentSince Apr 1, 2020 Accepting new patients
San Luis Walk-in Clinic, Inc. CurrentSince Apr 1, 2020 Accepting new patients
Regional Center for Border Health, Inc Clinical PastSince Sep 5, 2023 Accepting new patients

Locations

1980 Mesquite Ave
Lk Havasu Cty, AZ 86403
Phone (928) 392-3691

601 W Riverside Dr
Ste 4
Parker, AZ 85344
Phone (928) 256-4110

214 W Main St
Somerton, AZ 85350
Phone (928) 627-1120

950 E Main St
Bldg B
Somerton, AZ 85350
Phone (928) 236-8001

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11823/brand/2/csg/41/fhir/r4

Organizations & group practices 5

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": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1528691235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 617",
            "city": "SOMERTON",
            "state": "AZ",
            "postal_code": "853500617",
            "telephone_number": "928-315-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 E MAIN ST BLDG B",
            "city": "SOMERTON",
            "state": "AZ",
            "postal_code": "853507409",
            "telephone_number": "928-236-8001",
            "fax_number": "928-722-6113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENZUELA",
        "first_name": "ALEX",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-20",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-18495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003357",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerton, AZ

Sources for this page

Verify at the official NPI Registry.