OPTUMCARE NEW MEXICO, LLC (NPI# 1588947485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588947485 |
| Entity Type | Organization |
| Organization Name | OPTUMCARE NEW MEXICO, LLC |
| Other Organization Name | DAVITA MEDICAL GROUP |
| Practice Address |
5150 Journal Center Blvd Ne Albuquerque NM 87109-5900 |
| Mailing Address |
Po Box 26028 Albuquerque NM 87125-6028 |
| Practice Telephone | 5052623370 |
| Practice Fax Number | 5052623226 |
| Mailing Telephone | 5052627960 |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2019-08-22 |
| Authorized Official Name | JOHN G LIETHEN (SECRETARY) |
| Authorized Official Telephone | 9522056262 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| Other Name | Type Code |
|---|---|
| DaVita Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174025191 | Optumcare New Mexico, LLC | Durable Medical Equipment & Medical Supplies | 5150 Journal Center Blvd Ne Fl 2, Albuquerque, NM 87109-5900 | 2018-03-06 |
| 1326338963 | Optumcare New Mexico, LLC | Nurse Practitioner | 5400 Gibson Blvd Se, Albuquerque, NM 87108-4729 | 2011-04-17 |
| 1245494723 | Optumcare New Mexico, LLC | Radiologic Technologist | 5150 Journal Center Blvd Ne, Albuquerque, NM 87109-5900 | 2008-07-15 |
| 1851497663 | Optumcare New Mexico, LLC | General Practice | 4700 Jefferson St Ne, Suite 800, Albuquerque, NM 87109-2136 | 2006-09-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | OPTUMCARE NEW MEXICO, LLC | 534 Butte Ave, Pacific, WA 98047-1413 |
| Street Address |
5150 JOURNAL CENTER BLVD NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87109-5900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245230135 | Cecilia L Concepcion | Pediatrics | 5150 Journal Center Blvd Ne, Albuquerque, NM 87109-5900 | 2005-07-21 |
| 1790200392 | Ronald Mark Edwards | Nurse Practitioner | 5150 Journal Center Blvd Ne, Albuquerque, NM 87109 | 2017-08-04 |
| 1154859882 | Theresa Marie Toomey | Nurse Practitioner | 5150 Journal Center Blvd Ne, Albuquerque, NM 87109-5900 | 2017-05-25 |
| 1972037695 | Susan Teresa Rossi | Pharmacist | 5150 Journal Center Blvd Ne, Albuquerque, NM 87109-5900 | 2017-04-19 |
| 1104350602 | Julie Marie Gibson | Registered Nurse | 5150 Journal Center Blvd Ne, Davita Medical Group Coumadin Clinic, Albuquerque, NM 87109-5900 | 2017-04-12 |
| 1710426085 | Luz Lavezo | Pharmacist | 5150 Journal Center Blvd Ne, Albuquerque, NM 87109-5900 | 2017-02-19 |
| 1124561790 | Arlette Marie Atencio | Nurse Practitioner | 5150 Journal Center Blvd Ne, Albuquerque, NM 87109-5900 | 2016-11-29 |
| 1699169912 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 5150 Journal Center Blvd Ne, Albuquerque, NM 87109-5900 | 2015-03-25 |
| 1083020846 | Kelsey Hornsby | Pharmacist | 5150 Journal Center Blvd Ne, Albuquerque, NM 87109-5900 | 2014-07-01 |
| 1982019097 | Jayce Powell | Nurse Practitioner | 5150 Journal Center Blvd Ne, 2nd Floor Hand Clinic, Albuquerque, NM 87109-5900 | 2014-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386286367 | Mikaela Epaloose | Behavior Technician | 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-10-11 |
| 1245872464 | Marsha Director | Behavior Technician | 100 Sun Avenue Ne, Ste 650, Albuquerque, NM 87109 | 2019-10-09 |
| 1720637499 | Nancy Gail Vice | Technician | 7319 Laguna Niguel Drive Ne, Albuquerque, NM 87109 | 2019-09-05 |
| 1598314411 | Chau Vu | Behavior Technician | Attn: Behavioral Health Works 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-09-04 |
| 1932753498 | Noelle Nielsen | Behavior Technician | 6401 Academy Rd. Ne Apt. 189, Albuquerque, NM 87109 | 2019-08-01 |
| 1952967952 | Caridad Merkel | Obstetrics & Gynecology | 6100 Pan American Fwy Ne Suite 450, Albuquerque, NM 87109 | 2019-05-15 |
| 1043795149 | Margaret Mcconville | Physical Therapist | Lovelace Women's Hospital Outpatient Rehabilitation, 4600 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-09-25 |
| 1922586262 | Clark Endodontics LLC | Dentist | 7520 Montgomery Blvd Ne Bldg E1, Albuquerque, NM 87109 | 2018-07-30 |
| 1447736202 | Melissa Christine Scott | Registered Nurse | Lovelace Women's Hospital, 4701 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-07-16 |
| 1508351990 | Gianna Nicole Casarez-quintana | Dentist | 7520 Montgomery Blvd Ne Bldg E10, Albuquerque, NM 87109 | 2018-06-27 |
| Find all providers in zip 87109 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316508955 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 6500 Holly Ave Ne Ste D1d2, Albuquerque, NM 87113-2147 | 2019-06-25 |
| 1669833166 | Casey Optical Too | Eyewear Supplier (Equipment, not the service) | 121 Eubank Blvd Ne, Suite C, Albuquerque, NM 87123-2744 | 2016-03-10 |
| 1871852210 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | Kirtland Afb Building 20170, Albuquerque, NM 87117 | 2012-05-04 |
| 1942443825 | Precision Optical Laboratory, L.L.C. | Eyewear Supplier (Equipment, not the service) | 5115 Coors Blvd., N.w., Suite E, Albuquerque, NM 87120-1926 | 2009-04-08 |
| 1871778811 | Optic Expressions Eyewear | Eyewear Supplier (Equipment, not the service) | 6921 Montgomery Ne, Albuquerque, NM 87109 | 2008-01-09 |
| 1508057803 | Essilor Laboratories of America, Inc | Eyewear Supplier (Equipment, not the service) | 120 Jefferson St Ne, Albuquerque, NM 87108-1217 | 2007-08-05 |
| 1174743280 | Fashion Optical and Sunwear | Eyewear Supplier (Equipment, not the service) | 7415 Menaul Blvd Ne, Albuquerque, NM 87110 | 2007-04-30 |
| 1720133549 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | 4200 Wyoming Boulevard Ne, Albuquerque, NM 87111 | 2007-01-24 |
| 1518021534 | Muller Optical Inc | Eyewear Supplier (Equipment, not the service) | 9000 Menaul Blvd Ne, Albuquerque, NM 87112 | 2006-12-21 |
| 1144384561 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 5504 Menaul Blvd Ne, Plaza De La Sierra Ste #a, Albuquerque, NM 87110-3183 | 2006-12-20 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87109 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.