Individual provider Active NPI

Deborah Prair Berest, CNP

  • Family Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1801396585
Registry record updated Dec 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP-03512 Issued in NM
Practice address
9388 Valley View Dr NW Ste 300
Albuquerque, NM 87114-4908
Phone
(505) 338-3702
NPI assigned
Feb 19, 2018
Last updated
Dec 10, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP-03512 NM Primary
Hospice Registered Nurse 163WH1000X R48866 NM

Addresses

Primary practice location

9388 Valley View Dr NW Ste 300
Albuquerque, NM 87114-4908

Mailing address

5033 Agua Fria Park Rd
Santa Fe, NM 87507-3424
Phone (505) 699-7323

Other practice location 1

150 S Saint Francis Dr
Santa Fe, NM 87501-2445
Phone (505) 257-5253

Other practice location 2

511 W Cordova Rd
Santa Fe, NM 87505-1843
Phone (505) 983-5546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20201022001833 TX Practitioner - Nurse Practitioner 0941564363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kewa Pueblo Health CorporationGroup PAC ID 7618137779, 29 clinicians

Practice addresses (Care Compare)

85 W Hwy 22
Santo Domingo Pueblo, NM 87052-1283
Phone (505) 465-3060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R48866NMMDHospice Registered Nurse
CNP-03512NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kewa Pueblo Health Corporation CurrentSince Sep 8, 2020 Accepting new patients
Kewa Pueblo Health Corporation Past Accepting new patients

Locations

85 W Highway 22
Santo Domingo Pueblo, NM 87052
Phone (505) 465-3060

Interoperability endpoints

  • Direct secure messaging: deborah.breset.p1@direct.kp-hc.nextgenshare.com

Organizations & group practices 2

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": "1518998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1801396585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5033 AGUA FRIA PARK RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875073424",
            "telephone_number": "505-699-7323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9388 VALLEY VIEW DR NW STE 300",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871144908",
            "telephone_number": "505-338-3702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 S Saint Francis Dr",
            "address_purpose": "LOCATION",
            "city": "Santa Fe",
            "state": "NM",
            "postal_code": "875012445",
            "country_code": "US",
            "telephone_number": "505-257-5253",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "511 W Cordova Rd",
            "address_purpose": "LOCATION",
            "city": "Santa Fe",
            "state": "NM",
            "postal_code": "875051843",
            "country_code": "US",
            "telephone_number": "505-983-5546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEREST",
        "first_name": "DEBORAH",
        "middle_name": "PRAIR",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-19",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP-03512",
            "primary": true
        },
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "NM",
            "license": "R48866",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.