Individual provider Active NPI

Maria Theresa Becerra, FNP

  • Family Nurse Practitioner
  • Santa Teresa, NM
National Provider Identifier
1568427466
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
539455 Issued in TX
Practice address
5290 McNutt Rd Unit 2
Santa Teresa, NM 88008-2002
Phone
(575) 589-1144
Fax
(575) 589-2008
NPI assigned
Apr 20, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 539455 TX Primary

Addresses

Primary practice location

5290 McNutt Rd Unit 2
Santa Teresa, NM 88008-2002

Mailing address

5290 McNutt Rd
Santa Teresa, NM 88008-2001
Phone (575) 589-1144

Other identifiers 1

IdentifierTypeStateIssuer
178993503MedicaidTX

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
I20150106001156 NM Practitioner - Nurse Practitioner 0446231302 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors of Santa Teresa PC CurrentSince Nov 10, 2014 Accepting new patients
Edward C. Juarez, MD, PA Past Accepting new patients
Las Palmas del Sol Cardiology, PLLC Past Accepting new patients
Gary Grindstaff Dpmpa Past Accepting new patients
Santa Teresa Medical Care Center PC Past Accepting new patients
Cardiology Care Consultants, PA Past Accepting new patients

Locations

5290 McNutt Rd
Unit 2
Santa Teresa, NM 88008
Phone (575) 589-1144

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1568427466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5290 MCNUTT RD",
            "city": "SANTA TERESA",
            "state": "NM",
            "postal_code": "880082001",
            "telephone_number": "575-589-1144",
            "fax_number": "575-589-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5290 MCNUTT RD UNIT 2",
            "city": "SANTA TERESA",
            "state": "NM",
            "postal_code": "880082002",
            "telephone_number": "575-589-1144",
            "fax_number": "575-589-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECERRA",
        "first_name": "MARIA",
        "middle_name": "THERESA",
        "name_prefix": "Prof.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "539455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178993503",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Teresa, NM

Sources for this page

Verify at the official NPI Registry.