Kristin Peralta, LSAA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CTB-2022-0296 Issued in NM

Practice address

1107 S Atkinson Ave
Roswell, NM 88203-7154

Phone

(575) 578-4826

Fax

(575) 578-4828

NPI assigned

Dec 2, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Recovery Services of New Mexico, LLC

  • Methadone Clinic
  • Roswell, NM
  • NPI 1194104141
  NPD (past)
• Recovery Services of New Mexico, LLC

  • Addiction Medicine (Family Medicine) Physician
  • Albuquerque, NM
  • NPI 1861848632

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669939200000",
    "number": "1760192413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 S ATKINSON AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882037154",
            "telephone_number": "575-578-4826",
            "fax_number": "575-578-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 S ATKINSON AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882037154",
            "telephone_number": "575-578-4826",
            "fax_number": "575-578-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERALTA",
        "first_name": "KRISTIN",
        "name_prefix": "Mrs.",
        "credential": "LSAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-02",
        "last_updated": "2022-12-02",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "CTB-2022-0296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15743304",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pecos Valley Eye Surgery Center, LLC
• Pecos Valley Public Services
• Pecos Valley Sleep Center LLC
• Pecos Valley Wellness LLC
• Hyland C Peek, MOT, OTR/L
• Cheyann Perez
• Katheryne Perez
• Kimberly Kay Perez, MA CCC-SLP
• Tasha Perez, PTA
• Jon E Perry, PA

• Addiction (Substance Use Disorder) Counselor in Roswell, NM
• Providers in Roswell, NM by specialty
• Addiction (Substance Use Disorder) Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2022; 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.