Individual provider Active NPI

James Kuzava, LISW

  • Social Worker
  • Las Vegas, NM
National Provider Identifier
1639267289
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
I1038 Issued in NM
Practice address
700 Friedman Ave
Las Vegas, NM 87701-4231
Phone
(505) 454-5100
NPI assigned
Oct 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X I1038 NM Primary

Addresses

Primary practice location

700 Friedman Ave
Las Vegas, NM 87701-4231

Mailing address

700 Friedman Ave
Las Vegas, NM 87701-4231
Phone (505) 454-5100

Other identifiers 1

IdentifierTypeStateIssuer
Z0705MedicaidNM

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100630000712 NM Practitioner - Clinical Social Worker 9739127242 Practice locations: Santa Fe, NM

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2204 Brothers Rd
Suite B
Santa Fe, NM 87505-6975
Phone (505) 470-5318

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I1038NMMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639267289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 FRIEDMAN AVE",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014231",
            "telephone_number": "505-454-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 FRIEDMAN AVE",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014231",
            "telephone_number": "505-454-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUZAVA",
        "first_name": "JAMES",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "I1038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z0705",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NM

Sources for this page

Verify at the official NPI Registry.