Individual provider Active NPI

Marino Vigil Sr., LCSW

  • Clinical Social Worker
  • Farmington, NM
National Provider Identifier
1821444118
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SWB-2022-0067 Issued in NM
Practice address
1615 Ojo CT.
Farmington, NM 87401
Phone
(505) 564-4804
NPI assigned
May 5, 2016
Last updated
Apr 13, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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-2022-0067 NM Primary

Addresses

Primary practice location

1615 Ojo CT.
Farmington, NM 87401

Mailing address

PO Box 5190
Farmington, NM 87499-5190
Phone (505) 327-7218

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
I20220707002185 NM Practitioner - Clinical Social Worker 8820478951 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
Presbyterian Medical ServicesGroup PAC ID 2062324684, 132 clinicians

Practice addresses (Care Compare)

1001 W Broadway
Suite D
Farmington, NM 87401-5638
Phone (505) 327-4796

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SWB-2022-0067NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Medical Services CurrentSince May 1, 2022 Accepting new patients
Presbyterian Medical Services CurrentSince May 1, 2022 Accepting new patients
Presbyterian Medical Services Current Accepting new patients
Totah Behavioral Health Authority Past Accepting new patients

Locations

1001 W Broadway
Ste D
Farmington, NM 87401
Phone (505) 325-0238

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

Organizations & group practices 4

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": "1462406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1821444118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5190",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874995190",
            "telephone_number": "505-327-7218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 OJO CT.",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "87401",
            "telephone_number": "505-564-4804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIGIL",
        "first_name": "MARINO",
        "name_suffix": "Sr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-05",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2022-0067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.