Individual provider Active NPI

Tracy Rose Chacon

  • Clinical Social Worker
  • Albuquerque, NM
National Provider Identifier
1962812412
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1709 Moon St NE
Albuquerque, NM 87112-3935
Phone
(505) 271-4957
Fax
(505) 271-4957
NPI assigned
May 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

1709 Moon St NE
Albuquerque, NM 87112-3935

Mailing address

1101 Lopez Rd SW
Albuquerque, NM 87105
Phone (505) 877-7060

Other practice location 1

1101 Lopez Rd SW
Albuquerque, NM 87105
Phone (505) 877-7060

Other practice location 2

8401 Constitution Ave NE
Albuquerque, NM 87110-7604
Phone (505) 271-0329

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
I20211006000649 NM Practitioner - Clinical Social Worker 6002213584

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Unica PastSince May 16, 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1399334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1962812412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 LOPEZ RD SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87105",
            "telephone_number": "505-877-7060",
            "fax_number": "505-877-7063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 MOON ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871123935",
            "telephone_number": "505-271-4957",
            "fax_number": "505-271-4957"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Lopez Rd SW",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "87105",
            "country_code": "US",
            "telephone_number": "505-877-7060",
            "fax_number": "505-877-7063",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8401 Constitution Ave NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871107604",
            "country_code": "US",
            "telephone_number": "505-271-0329",
            "fax_number": "505-271-0329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHACON",
        "first_name": "TRACY",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-06",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "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.