Individual provider Active NPI

Alexandra Nutima

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1831563287
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
6505 Kaas Trail CT NE
Albuquerque, NM 87111-7114
Phone
(505) 400-6163
NPI assigned
Nov 23, 2015
Last updated
Nov 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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 Primary

Addresses

Primary practice location

6505 Kaas Trail CT NE
Albuquerque, NM 87111-7114

Mailing address

10200 Green River PL NW
Albuquerque, NM 87114-3965
Phone (623) 533-2997

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
I20240318001238 NM Practitioner - Clinical Social Worker 4183061807 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metta Therapeutics LLCGroup PAC ID 4183021736, 2 clinicians

Practice addresses (Care Compare)

6505 Kaas Trail CT NE
Albuquerque, NM 87111-7114
Phone (505) 400-6163

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Metta Therapeutics LLC Clinical CurrentSince Feb 3, 2024 Accepting new patients

Organizations & group practices 1

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": "1448236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1831563287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 GREEN RIVER PL NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871143965",
            "telephone_number": "623-533-2997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6505 KAAS TRAIL CT NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871117114",
            "telephone_number": "505-400-6163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTIMA",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-23",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.