| Genesis Eldercare Physician Services Llc | |
|
7900 Constitution Ave Ne Albuquerque NM 87110 | |
| (410) 769-7859 | |
| Not Available |
| Full Name | Genesis Eldercare Physician Services Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7900 Constitution Ave Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Eric Shapiro (VICE PRESIDENT) |
| Authorized Official Contact | 4108327790 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Eldercare Physician Services Llc Po Box 62946 Baltimore MD 21264-2946 Ph: (410) 494-7607 | Genesis Eldercare Physician Services Llc 7900 Constitution Ave Ne Albuquerque NM 87110 Ph: (410) 769-7859 |
| NPI Number | 1548615313 |
|---|---|
| Provider Enumeration Date | 04/29/2016 |
| Last Update Date | 08/05/2019 |
| Medicare PECOS PAC ID | 9830002534 |
|---|---|
| Medicare Enrollment ID | O20170619000933 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548615313 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Diane H Cummings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538149190 PECOS PAC ID: 6608875075 Enrollment ID: I20061212000536 |
| Provider Name | Emily Rothman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124119698 PECOS PAC ID: 9234037086 Enrollment ID: I20100917000585 |
| Provider Name | Jennifer Lynne Pantoja |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841782877 PECOS PAC ID: 5597011163 Enrollment ID: I20180712000493 |
| Provider Name | Anna Munoz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710452370 PECOS PAC ID: 2860737665 Enrollment ID: I20181226001071 |
| Provider Name | Nagendra Sarat Chandra Ayyagari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851629521 PECOS PAC ID: 9335304849 Enrollment ID: I20190610001422 |
| Provider Name | Gopi Mara Koosham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235660101 PECOS PAC ID: 9133490402 Enrollment ID: I20200708002130 |
| Provider Name | Scott Bolhack |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730160573 PECOS PAC ID: 8426962424 Enrollment ID: I20210303002877 |
| Provider Name | Andres D Plaza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245893445 PECOS PAC ID: 1153658125 Enrollment ID: I20220722000577 |
| Provider Name | Savanna Lee Noel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306570858 PECOS PAC ID: 6901272137 Enrollment ID: I20221013000642 |
| Provider Name | Bethany Alise Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215233721 PECOS PAC ID: 6103299391 Enrollment ID: I20230309001332 |
| Provider Name | Margarita Stella Turk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538849203 PECOS PAC ID: 8022462779 Enrollment ID: I20230928001977 |
| Provider Name | Cassandra Marie Edlund |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497408314 PECOS PAC ID: 0244689792 Enrollment ID: I20231211000246 |
| Provider Name | Carrie Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619678521 PECOS PAC ID: 1557705894 Enrollment ID: I20240214004385 |
| Provider Name | Cecelia D Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265140032 PECOS PAC ID: 9739550047 Enrollment ID: I20241002003707 |
| Provider Name | Getnet Tiku |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487488490 PECOS PAC ID: 5193256915 Enrollment ID: I20241004000068 |
| Provider Name | Erin Mintle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245858455 PECOS PAC ID: 5395158018 Enrollment ID: I20241104003933 |
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Gabriella Good Md Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3015 Indian Farm Ln Nw, Albuquerque, NM 87107 Phone: 505-259-8694 Fax: 186-660-7177 | |
Hands On Health Care, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3825 Eubank Blvd Ne Ste C, Albuquerque, NM 87111 Phone: 505-298-8020 | |
Maranllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10401 Montgomery Pkwy Ne, Albuquerque, NM 87111 Phone: 505-234-1040 Fax: 505-293-7183 | |
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