Individual provider Active NPI

Eugene Gerard Marciniak, MD

  • Internal Medicine Physician
  • Las Cruces, NM
National Provider Identifier
1407830458
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2000237 Issued in NM
Practice address
999 W Amador Ave Ste a
Las Cruces, NM 88005-2739
Phone
(575) 527-5482
Fax
(575) 525-3542
NPI assigned
Dec 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2000237 NM Primary

Addresses

Primary practice location

999 W Amador Ave Ste a
Las Cruces, NM 88005-2739

Mailing address

999 W Amador Ave Ste a
Las Cruces, NM 88005-2739
Phone (575) 527-5482

Other identifiers 1

IdentifierTypeStateIssuer
68979MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20241231001269 NM Practitioner - Internal Medicine 5890004659 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Indiana University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amador Health Center, Inc. 9 clinicians

Practice addresses (Care Compare)

999 W Amador Ave a
Las Cruces, NM 88005-2739
Phone (575) 527-5482

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2000237NMMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amador Health Center, Inc. CurrentSince Oct 13, 2024 Accepting new patients
Amador Health Center, Inc. CurrentSince Oct 13, 2024 Accepting new patients

Locations

999 W Amador Ave
Las Cruces, NM 88005
Phone (575) 527-5482

999 W Amador Ave
Ste A
Las Cruces, NM 88005
Phone (575) 527-5482

Interoperability endpoints

  • Direct secure messaging: eugene.marciniak.1@27572.direct.athenahealth.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1407830458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 W AMADOR AVE STE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880052739",
            "telephone_number": "575-527-5482",
            "fax_number": "575-525-3542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 W AMADOR AVE STE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880052739",
            "telephone_number": "575-527-5482",
            "fax_number": "575-525-3542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCINIAK",
        "first_name": "EUGENE",
        "middle_name": "GERARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "2000237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "68979",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

Verify at the official NPI Registry.