Individual provider Active NPI

Marilou Linatoc, N.P.

  • Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1679506349
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP01894 Issued in NM
Practice address
717 Encino PL NE
Suite 4
Albuquerque, NM 87102-2611
Phone
(505) 508-3458
Fax
(505) 433-2475
NPI assigned
Jul 8, 2006
Last updated
Dec 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209000432 IL
Nurse Practitioner 363L00000X CNP01894 NM Primary

Addresses

Primary practice location

717 Encino PL NE
Suite 4
Albuquerque, NM 87102-2611

Mailing address

717 Encino PL NE
Suite 4
Albuquerque, NM 87102-2611
Phone (505) 508-3458

Other identifiers 1

IdentifierTypeStateIssuer
78071241MedicaidNM

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
I20120229000601 NM Practitioner - Nurse Practitioner 0941267132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Life Family Healthcare, LLCGroup PAC ID 0345536975, 2 clinicians

Practice addresses (Care Compare)

717 Encino PL NE
Suite 4
Albuquerque, NM 87102-2624
Phone (505) 508-3458

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP01894NMMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Life Family Healthcare, LLC CurrentSince Sep 1, 2016 Accepting new patients
Waukegan Clinic Corp Past Accepting new patients
Saint Anthonys Health Center Past Accepting new patients
Northwest Community Hospital Past Accepting new patients
Hashemi Medical Group S C Nurse Practitioner PastSince Mar 26, 2007 Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients

Locations

717 Encino Pl NE
Ste 4
Albuquerque, NM 87102
Phone (505) 243-2323

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2069/brand/1/csg/29/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/22688/brand/1/csg/1/fhir/r4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1679506349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 ENCINO PL NE",
            "address_2": "SUITE 4",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022611",
            "telephone_number": "505-508-3458",
            "fax_number": "505-433-2475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 ENCINO PL NE",
            "address_2": "SUITE 4",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022611",
            "telephone_number": "505-508-3458",
            "fax_number": "505-433-2475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINATOC",
        "first_name": "MARILOU",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-08",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209000432",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "CNP01894",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78071241",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.