NPIMap

Organization Active NPI

Omnisleep LLC

  • Sleep Disorder Diagnostic Clinic/Center
  • Albuquerque, NM
National Provider Identifier
1164410528
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X
Legal business name
OMNISLEEP LLC
Practice address
3810 Masthead St NE
Albuquerque, NM 87109-4479
Phone
(505) 843-8758
Fax
(505) 843-8759
NPI assigned
Oct 10, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Authorized official

Name
John Craig EavesNPI 1437147899
Title
Ceo
Phone
(505) 843-8758

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 7

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X
Respiratory/Developmental/Rehabilitative Specialist/TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 225500000X
Certified Respiratory TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 227800000X
Registered Respiratory TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 227900000X
Other Specialist/TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 246Z00000X
Sleep Disorder Diagnostic Clinic/Center 261QS1200X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

3810 Masthead St NE
Albuquerque, NM 87109-4479

Mailing address

3810 Masthead St NE
Albuquerque, NM 87109-4479
Phone (505) 843-8758

Other identifiers 2

IdentifierTypeStateIssuer
95877321MedicaidNM
81323395MedicaidNM

Other names 1

  • OmniSleep Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050907000684 NM Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 1658303987 Practice locations: Albuquerque, NM

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

801 Encino Pl NE
Ste F1
Albuquerque, NM 87102
Phone (505) 843-8758

6500 Jefferson St NE
Ste 101
Albuquerque, NM 87109
Phone (505) 843-8758

801 Encino Pl NE
Ste F4
Albuquerque, NM 87102
Phone (505) 349-5180

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591747200000",
    "number": "1164410528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 MASTHEAD ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094479",
            "telephone_number": "505-843-8758",
            "fax_number": "505-843-8759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 MASTHEAD ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094479",
            "telephone_number": "505-843-8758",
            "fax_number": "505-843-8759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNISLEEP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-10",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A",
        "authorized_official_last_name": "EAVES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CRAIG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-843-8758"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "227800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Respiratory Therapist, Certified",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "227900000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Respiratory Therapist, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95877321",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81323395",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OmniSleep",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.