Organization Active NPI

Genevive Aco LLC

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Minneapolis, MN
National Provider Identifier
1053200543
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
Legal business name
GENEVIVE ACO LLC
Practice address
3433 Broadway St NE Ste 300
Minneapolis, MN 55413-1761
Phone
(763) 587-7737
Fax
(651) 383-4551
NPI assigned
Jun 30, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Authorized official

Name
Dr. Jennifer Welsh, MDNPI 1215045885
Title
Chief Medical Officer
Phone
(763) 587-7737

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QH0002X Primary

Addresses

Primary practice location

3433 Broadway St NE Ste 300
Minneapolis, MN 55413-1761

Mailing address

3433 Broadway St NE Ste 300
Minneapolis, MN 55413-1761
Phone (763) 587-7737

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250730000344 MN Part B Supplier - Clinic/Group Practice 8628585080 Receives reassigned benefits from 44 practitioners
Practice locations: Minneapolis, MN

National Provider Directory

National Provider Directory

Locations

3433 Broadway St NE
Ste 300
Minneapolis, MN 55413

Practitioners & affiliated clinicians

Practitioners 50

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1751241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751241600000",
    "number": "1053200543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 BROADWAY ST NE STE 300",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131761",
            "telephone_number": "763-587-7737",
            "fax_number": "651-383-4551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3433 BROADWAY ST NE STE 300",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131761",
            "telephone_number": "763-587-7737",
            "fax_number": "651-383-4551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENEVIVE ACO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-30",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A",
        "authorized_official_last_name": "WELSH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "763-587-7737",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.