Active NPI
Deborah Prair Berest, CNP
- Family Nurse Practitioner
- Albuquerque, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- CNP-03512
- 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, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| R48866 | NM | MD | Hospice Registered Nurse |
| CNP-03512 | NM | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kewa Pueblo Health Corporation | Current | 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
- 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.
-
- Federally Qualified Health Center (FQHC)
- Santo Domingo Pueblo, NM
- NPI 1467739888
TX
-
- Community/Behavioral Health Agency
- Santo Domingo Pueblo, NM
- NPI 1336659077
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.