Individual provider Active NPI

Maria De Jesus Roldan, LCSW

  • Clinical Social Worker
  • Belen, NM
National Provider Identifier
1790238343
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SWB-2022-1033 Issued in NM
Practice address
838 W Didier Ave
Belen, NM 87002-3160
Phone
(505) 312-0040
NPI assigned
Aug 1, 2016
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 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 SWB-2022-1033 NM Primary

Addresses

Primary practice location

838 W Didier Ave
Belen, NM 87002-3160

Mailing address

838 W Didier Ave
Belen, NM 87002-3160
Phone (505) 312-0040

Other practice location 1

575 S Alameda Blvd
Las Cruces, NM 88005-2818
Phone (575) 449-4000

Other practice location 2

100 W Griggs Ave
Las Cruces, NM 88001-1234
Phone (575) 647-2800

Other practice location 3

118 S Main St
Las Cruces, NM 88001-1266
Phone (575) 647-2800

Other identifiers 1

IdentifierTypeStateIssuer
10124314MedicaidNM

Other names 1

  • Maria De Jesus Meraz Former name

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
I20230125002188 NM Practitioner - Clinical Social Worker 9638540867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heart and Soul of NM, IncGroup PAC ID 4587052873, 19 clinicians

Practice addresses (Care Compare)

1300 E River Rd
Apt B
Belen, NM 87002-7426
Phone (505) 312-0040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Heart & Soul of NM, Inc Clinical CurrentSince Dec 1, 2022 Accepting new patients

Locations

838 W Didier Ave
Belen, NM 87002
Phone (505) 312-0040

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": "1470009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1790238343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "838 W DIDIER AVE",
            "city": "BELEN",
            "state": "NM",
            "postal_code": "870023160",
            "telephone_number": "505-312-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "838 W DIDIER AVE",
            "city": "BELEN",
            "state": "NM",
            "postal_code": "870023160",
            "telephone_number": "505-312-0040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "575 S Alameda Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880052818",
            "country_code": "US",
            "telephone_number": "575-449-4000",
            "fax_number": "575-449-4021",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 W Griggs Ave",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880011234",
            "country_code": "US",
            "telephone_number": "575-647-2800",
            "fax_number": "575-647-2898",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "118 S Main St",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880011266",
            "country_code": "US",
            "telephone_number": "575-647-2800",
            "fax_number": "575-647-2898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROLDAN",
        "first_name": "MARIA",
        "middle_name": "DE JESUS",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-01",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2022-1033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10124314",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "MERAZ",
            "middle_name": "DE JESUS",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Belen, NM

Sources for this page

Verify at the official NPI Registry.