Individual provider Active NPI

Kimberly Peck, CNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1891470829
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
63424 Issued in NM
Practice address
2600 Marble Ave NE
Albuquerque, NM 87106-2058
Phone
(505) 272-2920
NPI assigned
Jun 19, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 63424 NM Primary

Addresses

Primary practice location

2600 Marble Ave NE
Albuquerque, NM 87106-2058

Mailing address

2600 Marble Ave NE
Albuquerque, NM 87106-2058

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: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230822000430 NM Practitioner - Nurse Practitioner 7214399351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

1100 Central Ave SE
Albuquerque, NM 87106-4930
Phone (505) 841-1234

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
63424NMMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Sep 12, 2023 Accepting new patients
Presbyterian Healthcare Services Current Accepting new patients
Presbyterian Healthcare Services CurrentSince Sep 12, 2023 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

8312 Kaseman Ct NE
Albuquerque, NM 87110
Phone (505) 291-2200

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

1010 Spruce St
Espanola, NM 87532
Phone (505) 367-0340

211 Sudderth Dr
Ruidoso, NM 88345
Phone (505) 257-7381

4801 Beckner Rd
Santa Fe, NM 87507
Phone (505) 772-1234

1202 Highway 60
Socorro, NM 87801
Phone (505) 835-1140

1202 Highway 60
Bldg D
Socorro, NM 87801
Phone (575) 838-4690

Interoperability endpoints

  • Direct secure messaging: kpeck237987@direct.phs.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1891470829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 MARBLE AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 MARBLE AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062058",
            "telephone_number": "505-272-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "KIMBERLY",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "63424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.