Individual provider Active NPI

Angela P Maes, LISW

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1821169616
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-05065 Issued in NM
Practice address
1803 Carlisle Blvd NE
Albuquerque, NM 87110-4905
Phone
(505) 842-9911
Fax
(505) 254-9911
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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 I-05065 NM Primary

Addresses

Primary practice location

1803 Carlisle Blvd NE
Albuquerque, NM 87110-4905

Mailing address

1803 Carlisle Blvd NE
Albuquerque, NM 87110-4905
Phone (505) 842-9911

Other identifiers 1

IdentifierTypeStateIssuer
36723550MedicaidNM

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
I20110407000949 NM Practitioner - Clinical Social Worker 8921282476 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I-05065NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Families Clinical Current Accepting new patients
Rise Integrated Health LLC Past Accepting new patients

Locations

1803 Carlisle Blvd NE
Albuquerque, NM 87110
Phone (505) 842-9911

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300752000000",
    "number": "1821169616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 CARLISLE BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104905",
            "telephone_number": "505-842-9911",
            "fax_number": "505-254-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 CARLISLE BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104905",
            "telephone_number": "505-842-9911",
            "fax_number": "505-254-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAES",
        "first_name": "ANGELA",
        "middle_name": "P",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2011-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "I-05065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36723550",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.