Individual provider Active NPI

Joel D Gelinas, PAC

  • Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1760417984
Registry record updated Jan 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2006-015 Issued in NM
Practice address
6801 Jefferson St NE
Suite 350
Albuquerque, NM 87109-4379
Phone
(505) 242-1711
Fax
(505) 242-0291
NPI assigned
Jul 12, 2006
Last updated
Jan 3, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2006-015 NM Primary

Addresses

Primary practice location

6801 Jefferson St NE
Suite 350
Albuquerque, NM 87109-4379

Mailing address

6801 Jefferson St NE
Suite 350
Albuquerque, NM 87109-4379
Phone (505) 242-1711

Other identifiers 1

IdentifierTypeStateIssuer
24950530MedicaidNM

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060922000494 NM Practitioner - Physician Assistant 8628071206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rehabilitation and Occupational Medicine LLCGroup PAC ID 8628963329, 2 clinicians

Practice addresses (Care Compare)

3530 Foothills Rd
Suite N
Las Cruces, NM 88011-3621
Phone (575) 532-6054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2006-015NMMDPhysician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294012800000",
    "number": "1760417984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 JEFFERSON ST NE",
            "address_2": "SUITE 350",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094379",
            "telephone_number": "505-242-1711",
            "fax_number": "505-242-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 JEFFERSON ST NE",
            "address_2": "SUITE 350",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094379",
            "telephone_number": "505-242-1711",
            "fax_number": "505-242-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELINAS",
        "first_name": "JOEL",
        "middle_name": "D",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2011-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2006-015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "24950530",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.