Individual provider Active NPI

Nelson Eric Gencheff, DO

  • Cardiovascular Disease Physician
  • Marquette, MI
National Provider Identifier
1073557435
Registry record updated Aug 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
5101009341 Issued in MI
Practice address
1414 West Fair Avenue
Suite 334
Marquette, MI 49855
Phone
(906) 225-3870
Fax
(906) 225-4861
NPI assigned
Jun 16, 2006
Last updated
Aug 22, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 5101009341 MI Primary

Addresses

Primary practice location

1414 West Fair Avenue
Suite 334
Marquette, MI 49855

Mailing address

1414 West Fair Avenue
Suite 334
Marquette, MI 49855
Phone (906) 225-3870

Other identifiers 4

IdentifierTypeStateIssuer
30054000MedicaidWI
3090816MedicaidMI
0655200055OtherMIBLUE CROSS BLUE SHIELD
060029051OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070326000385 MI Practitioner - Cardiovascular Disease (Cardiology) 6608970983 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1414 W Fair Ave
Marquette, MI 49855-2675

18341 US Hwy 41
Lanse, MI 49946-8024
Phone (906) 524-3300

500 Campus Dr
Hancock, MI 49930-1452

850 W Baraga Ave
Marquette, MI 49855-4550

901 Lakeshore Dr
Ishpeming, MI 49849-1367

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5697OHMDOptometrist
5101009341MIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Marquette Physician Practices Inc CurrentSince Sep 1, 2012 Accepting new patients
Portage Hospital LLC CurrentSince Jan 4, 2014 Accepting new patients
DLP Marquette Physician Practices Inc CurrentSince Sep 1, 2012 Accepting new patients
Upper Michigan Cardiovascular Associates, PC Cardiovascular Disease Current Accepting new patients
Portage Hospital LLC CurrentSince Jan 4, 2014 Accepting new patients
DLP Marquette Physician Practices Inc Past Accepting new patients
North Ohio Heart Center Inc Cardiovascular Disease Past Accepting new patients

Locations

500 Campus Dr
Hancock, MI 49930
Phone (906) 483-1000

894 Campus Dr
Ste B
Hancock, MI 49930
Phone (906) 483-1128

600 Macinnes Dr
Houghton, MI 49931
Phone (906) 483-1818

N10561 Grandview Ln
Ironwood, MI 49938
Phone (906) 932-1500

901 Lakeshore Dr
Ishpeming, MI 49849
Phone (906) 485-2653

205 Osceola St
Laurium, MI 49913
Phone (906) 337-3100

1414 W Fair Ave
Ste 334
Marquette, MI 49855
Phone (906) 225-3870

1414 W Fair Ave
Ste 344
Marquette, MI 49855
Phone (906) 225-3910

1414 W Fair Ave
Ste 36
Marquette, MI 49855
Phone (906) 225-3864

850 W Baraga Ave
Ste 20
Marquette, MI 49855
Phone (906) 449-3440

Interoperability endpoints

  • Direct secure messaging: nelson.gencheff.1@8233.direct.athenahealth.com
  • Direct secure messaging: nelson.gencheff@mghvi.directbygreenway.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377129600000",
    "number": "1073557435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 WEST FAIR AVENUE",
            "address_2": "SUITE 334",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "49855",
            "telephone_number": "906-225-3870",
            "fax_number": "906-225-4861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 WEST FAIR AVENUE",
            "address_2": "SUITE 334",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "49855",
            "telephone_number": "906-225-3870",
            "fax_number": "906-225-4861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENCHEFF",
        "first_name": "NELSON",
        "middle_name": "ERIC",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2013-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "5101009341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30054000",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3090816",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0655200055",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060029051",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

Verify at the official NPI Registry.