Individual provider Active NPI

Colby Mark Genrich

  • Sports Medicine (Family Medicine) Physician
  • El Paso, TX
National Provider Identifier
1134513229
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
S2310 Issued in TX
Practice address
9849 Kenworthy St
El Paso, TX 79924-4402
Phone
(915) 215-5500
Fax
(915) 215-8655
NPI assigned
Mar 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X S2310 TX Primary

Addresses

Primary practice location

9849 Kenworthy St
El Paso, TX 79924-4402

Mailing address

440 Raynolds St # 51015
El Paso, TX 79905-1613
Phone (915) 215-4479

Other practice location 1

799 Bloomfield Ave Ste 201
Verona, NJ 07044-1301
Phone (973) 746-7050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20190626001647 TX Practitioner - Family PracticePractitioner - Sports Medicine 2668762717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Tech University Health Sciences Center El PasoGroup PAC ID 7517864754, 306 clinicians

Practice addresses (Care Compare)

9849 Kenworthy St
El Paso, TX 79924-4402
Phone (915) 215-5000

Hospital & facility affiliations

  • University Medical Center of El Paso Hospital, El Paso, TX, CCN 450024

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Jul 1, 2019 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Jul 1, 2019 Accepting new patients
Texas Tech University Health Sciences Center Odessa Past Accepting new patients

Locations

4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200

9849 Kenworthy St
El Paso, TX 79924
Phone (915) 215-5500

4815 Alameda Ave
El Paso, TX 79905
Phone (915) 215-6000

125 W Hague Rd
Ste 340
El Paso, TX 79902
Phone (915) 213-5512

Interoperability endpoints

  • Direct secure messaging: colby.genrich@direct.myhealthep.org

Organizations & group practices 4

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

Hospital & facility affiliations 3

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": "1427328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1134513229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 RAYNOLDS ST # 51015",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799051613",
            "telephone_number": "915-215-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9849 KENWORTHY ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799244402",
            "telephone_number": "915-215-5500",
            "fax_number": "915-215-8655"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "799 Bloomfield Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Verona",
            "state": "NJ",
            "postal_code": "070441301",
            "country_code": "US",
            "telephone_number": "973-746-7050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GENRICH",
        "first_name": "COLBY",
        "middle_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-26",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TX",
            "license": "S2310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.