NPIMap

Organization Active NPI

Grand Summit LLC

  • Community/Behavioral Health Agency
  • Albuquerque, NM
National Provider Identifier
1750107199
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
GRAND SUMMIT LLC
Practice address
13139 Central Ave NE
Albuquerque, NM 87123-3031
Phone
(505) 595-1607
NPI assigned
Dec 2, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Authorized official

Name
Bakhtar EhsanNPI 1518704485
Title
Cfo
Phone
(831) 325-3541

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

13139 Central Ave NE
Albuquerque, NM 87123-3031

Mailing address

9909 Robin Ave NE
Albuquerque, NM 87112-4061
Phone (831) 325-3541

National Provider Directory

National Provider Directory
Tax ID family
Grand Summit LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

13139 Central Ave NE
Albuquerque, NM 87123
Phone (505) 575-1607

Practitioners & affiliated clinicians

Practitioners 96

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

View all 96

NPI Registry JSON

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

{
    "created_epoch": "1733097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747699200000",
    "number": "1750107199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9909 ROBIN AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871124061",
            "telephone_number": "831-325-3541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13139 CENTRAL AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871233031",
            "telephone_number": "505-595-1607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND SUMMIT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-02",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A",
        "authorized_official_last_name": "EHSAN",
        "authorized_official_first_name": "BAKHTAR",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "831-325-3541"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.