Individual provider Active NPI

Joshua A Eberle, LCSW

  • Clinical Social Worker
  • Santa Fe, NM
National Provider Identifier
1801117882
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C-11749 Issued in NM
Practice address
4730 Beckner Road
Santa Fe, NM 87507-3691
Phone
(055) 989-4500
Fax
(505) 443-8313
NPI assigned
Jun 14, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 082916-01 NY
Clinical Social Worker 1041C0700X L7021 OR
Clinical Social Worker 1041C0700X C-11749 NM Primary

Addresses

Primary practice location

4730 Beckner Road
Santa Fe, NM 87507-3691

Mailing address

2960 Rodeo Park Dr W
Santa Fe, NM 87505-6351

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
I20210812001451 NM Practitioner - Clinical Social Worker 0547664583 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
082916-01NYMDClinical Social Worker
L7021ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Medical Services Current Accepting new patients
Presbyterian Medical Services CurrentSince Aug 9, 2021 Accepting new patients
Presbyterian Medical Services CurrentSince Aug 9, 2021 Accepting new patients

Locations

4730 Beckner Rd
Santa Fe, NM 87507
Phone (505) 989-4500

1422 Paseo de Peralta
Santa Fe, NM 87501
Phone (505) 982-5565

2960 Rodeo Park Dr W
Santa Fe, NM 87505
Phone (505) 986-9633

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1801117882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 RODEO PARK DR W",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875056351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 BECKNER ROAD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875073691",
            "telephone_number": "055-989-4500",
            "fax_number": "505-443-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERLE",
        "first_name": "JOSHUA",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-14",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "082916-01",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L7021",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-11749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.