Individual provider Active NPI

Tawnia Manuelito, LCSW

  • Clinical Social Worker
  • Rio Rancho, NM
National Provider Identifier
1659846772
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
2300 Grande Blvd SE
Rio Rancho, NM 87124-1755
Phone
(505) 331-8743
NPI assigned
Oct 4, 2018
Last updated
Jun 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 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 Primary

Addresses

Primary practice location

2300 Grande Blvd SE
Rio Rancho, NM 87124-1755

Mailing address

2300 Grande Blvd SE Ste a
Rio Rancho, NM 87124-1755
Phone (505) 331-8743

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
I20190625002862 NM Practitioner - Clinical Social Worker 1557695558 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Medical ServicesGroup PAC ID 2062324684, 132 clinicians

Practice addresses (Care Compare)

2300 Grande Blvd SE
Rio Rancho, NM 87124-1636
Phone (505) 896-7100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Medical Services CurrentSince Feb 27, 2025 Accepting new patients
Presbyterian Medical Services Current Accepting new patients
Pueblo of Acoma Past Accepting new patients
Pueblo of Acoma Past Accepting new patients

Locations

184 Unser Blvd NE
Rio Rancho, NM 87124
Phone (505) 896-0928

2300 Grande Blvd SE
Rio Rancho, NM 87124
Phone (505) 896-0928

2300 Grande Blvd SE
Ste A
Rio Rancho, NM 87124
Phone (505) 896-0928

Organizations & group practices 4

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": "1538611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1659846772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 GRANDE BLVD SE STE A",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241755",
            "telephone_number": "505-331-8743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 GRANDE BLVD SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871241755",
            "telephone_number": "505-331-8743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANUELITO",
        "first_name": "TAWNIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-04",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

Verify at the official NPI Registry.