Individual provider Active NPI

Ariane Heila Mahmud-Ghazi, LCSW, LMT, SEP

  • Clinical Social Worker
  • Santa Fe, NM
National Provider Identifier
1659391936
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-07805 Issued in NM
Practice address
1422 4TH St Ste C
Santa Fe, NM 87505
Phone
(505) 570-1607
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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 C-07805 NM Primary

Addresses

Primary practice location

1422 4TH St Ste C
Santa Fe, NM 87505

Mailing address

1604 Young St
Santa Fe, NM 87505-3504
Phone (505) 570-1607

Other identifiers 1

IdentifierTypeStateIssuer
27984567MedicaidNM

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
I20061007000011 NM Practitioner - Clinical Social Worker 0345244703 Practice locations: Santa Fe, NM

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1422 4TH St
Santa Fe, NM 87505-3422
Phone (505) 570-1607

1604 Young St
Santa Fe, NM 87505-3504

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C-07805NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ariane Mahmud-Ghazi, LLC CurrentSince Aug 23, 2020 Accepting new patients

Organizations & group practices 1

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1659391936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 YOUNG ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875053504",
            "telephone_number": "505-570-1607",
            "fax_number": "505-995-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 4TH ST STE C",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "87505",
            "telephone_number": "505-570-1607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMUD-GHAZI",
        "first_name": "ARIANE",
        "middle_name": "HEILA",
        "name_prefix": "Ms.",
        "credential": "LCSW, LMT, SEP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-07805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "27984567",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.