Centennial Medical Group LLP

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CENTENNIAL MEDICAL GROUP LLP

Practice address

7800 Constitution Ave NE
Albuquerque, NM 87110-7552

Phone

(505) 296-6565

NPI assigned

Jul 8, 2025

Last updated

Jul 8, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kellie Merrill

Title

Director of Billing

Phone

(702) 839-1203

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Other NPIs with the same Medicare PAC ID 2

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

• Centennial Medical Group LLP

  • Durable Medical Equipment & Medical Supplies
  • Las Vegas, NV
  • NPI 1013807361

  6901807536

  Same PAC ID
• Centennial Medical Group LLP

  • Interventional Pain Medicine Physician
  • Las Vegas, NV
  • NPI 1073619359

  6901807536

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Centennial Medical Group LLP3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Centennial Medical Group

  dba Centennial Upright MRI

  • Interventional Pain Medicine Physician
  • N Las Vegas, NV
  • NPI 1598926677
  NPD tax ID
• Centennial Medical Group LLP

  • Durable Medical Equipment & Medical Supplies
  • Las Vegas, NV
  • NPI 1013807361
  NPD tax ID

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

{
    "created_epoch": "1751932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751932800000",
    "number": "1740170091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4454 N DECATUR BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891305286",
            "telephone_number": "702-893-1203",
            "fax_number": "702-893-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 CONSTITUTION AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871107552",
            "telephone_number": "505-296-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL MEDICAL GROUP LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-08",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A",
        "authorized_official_last_name": "MERRILL",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "702-839-1203"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juan Ceniceros
• Kimberly Branch Ceniceros
• Nicole Centazzo, MD
• Leandro Xavier Centenera, MD
• Luis Centenera, MD
• Center for Creative Studies LLC
• Center for Creative Studies LLC
• Center for Holistic Health LLC
• Center for Prenatal Development
• Center for Reproductive Medicine of New Mexico

• Durable Medical Equipment & Medical Supplies in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Durable Medical Equipment & Medical Supplies in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.