| 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 | Emily Rothman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124119698 PECOS PAC ID: 9234037086 Enrollment ID: I20100917000585 |
| Provider Name | Joanne Johnston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316256696 PECOS PAC ID: 9032177688 Enrollment ID: I20140121000291 |
| Provider Name | David Michael Greenberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003896408 PECOS PAC ID: 9133193477 Enrollment ID: I20140328000863 |
| Provider Name | Sheila Louise Hundley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821549643 PECOS PAC ID: 5294016713 Enrollment ID: I20161221000854 |
| 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 | Erin Mintle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245858455 PECOS PAC ID: 5395158018 Enrollment ID: I20210119001194 |
| Provider Name | Scott Bolhack |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730160573 PECOS PAC ID: 8426962424 Enrollment ID: I20210303002877 |
| 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 | Jennifer Dawn Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669253951 PECOS PAC ID: 2365891579 Enrollment ID: I20231213003350 |
| Provider Name | April E Kimball |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528373693 PECOS PAC ID: 1850562901 Enrollment ID: I20240109001284 |
| Provider Name | Carrie Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619678521 PECOS PAC ID: 1557705894 Enrollment ID: I20240214004385 |
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