Genesis Physician Associates LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD2006-0141 Issued in NM

Legal business name

GENESIS PHYSICIAN ASSOCIATES LLC

Practice address

4801 N Butler Avenue
Suite 8102
Farmington, NM 87401-0818

Phone

(505) 436-2671

NPI assigned

Aug 8, 2011

Last updated

Oct 29, 2020By 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

Uche Obisike, M.D.NPI 1265465884

Title

President

Phone

(505) 436-2671

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Genesis Physician Associates LLC

  dba Internal Medicine and Geriatric Associates

  • Internal Medicine Physician
  • Albuquerque, NM
  • NPI 1902465263

  O20111116000323

  Same enrollment

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Uche N Obisike, MD

  • Internal Medicine Physician
  • Rio Rancho, NM
  • NPI 1265465884
  Medicare reassignment Care Compare group NPD Authorized official
• Clarissa Silva, FNP-BC

  • Family Nurse Practitioner
  • Rio Rancho, NM
  • NPI 1124724646
  Medicare reassignment Care Compare group NPD
• Helen V. Fragua, PA-C,MSN

  • Medical Physician Assistant
  • Rio Rancho, NM
  • NPI 1437446374
  NPD (past)
• Kimberley B. Oldewage, PA-C

  • Physician Assistant
  • Rio Rancho, NM
  • NPI 1003183187
  NPD (past)

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603929600000",
    "number": "1740569763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 N BUTLER AVENUE",
            "address_2": "SUITE 8102",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874010818",
            "telephone_number": "505-436-2671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 N BUTLER AVENUE",
            "address_2": "SUITE 8102",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874010818",
            "telephone_number": "505-436-2671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS PHYSICIAN ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-08",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A",
        "authorized_official_last_name": "OBISIKE",
        "authorized_official_first_name": "UCHE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-436-2671",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "MD2006-0141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dmitry Garmaev
• Deborah E Gaudet, LPCC
• Pamela R Gaylord, OT
• Katie Darlene Gee
• Generations Personal Care, Inc
• Andres Gensini, MD
• George H Peacock MD PC
• Aimee Lucia Georgina
• Geps Physician Group of New Mexico, PC
• Matthew R Geter

• Internal Medicine Physician in Farmington, NM
• Providers in Farmington, NM by specialty
• Internal Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.