Miranda Nicholle Baca

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

2076 Issued in NM

Practice address

2501 San Pedro Drive NE #118
Albuquerque, NM 87110-4131

Phone

(505) 249-3826

Fax

(505) 212-4610

NPI assigned

May 18, 2026

Last updated

Sep 22, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• CJM Enterprise LLC

  • Case Manager/Care Coordinator
  • Albuquerque, NM
  • NPI 1760280796
  NPD (past)
• Themis Training and Consulting LLC

  dba Thunderbird Rising Recovery

  • Community/Behavioral Health Agency
  • Albuquerque, NM
  • NPI 1043755002
  NPD (past)

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

{
    "created_epoch": "1779062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1649109364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 SAN PEDRO DR NE # 118",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104131",
            "telephone_number": "505-249-3826",
            "fax_number": "505-212-4610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 SAN PEDRO DRIVE NE #118",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104131",
            "telephone_number": "505-249-3826",
            "fax_number": "505-212-4610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACA",
        "first_name": "MIRANDA",
        "middle_name": "NICHOLLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-18",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NM",
            "license": "2076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N0066580",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melanie Ann Baca, MD
• Michael James Baca
• Michelle Baca, LISW
• Michelle Ann Marie Baca
• Michelle Denise Baca, RN
• Monique C Baca, LMHC
• Nancy Baca
• Nicholas M Baca, LMT
• Nicole Baca, CPSW
• Philip Martin Baca, P.T.

• Peer Specialist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Peer Specialist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; 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.