Individual provider Active NPI

Charlesly Joseph, MD

  • Internal Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1770622714
Registry record updated Nov 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2006-0332 Issued in NM
Practice address
Unm Hospital Internal Medicine
Albuquerque, NM 87131-0001
Phone
(505) 272-6225
NPI assigned
Feb 6, 2007
Last updated
Nov 4, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2011

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 2006-0332 NM Primary

Addresses

Primary practice location

Unm Hospital Internal Medicine
Albuquerque, NM 87131-0001

Mailing address

2211 Lomas Blvd NE
MSC 084770
Albuquerque, NM 87131-0001

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
I20120201000789 NM Practitioner - Internal MedicinePractitioner - Nephrology 7416114566 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Warren Alpert Medical School of Brown University, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Mexico Pac Services PCGroup PAC ID 3072889211, 7 clinicians

Practice addresses (Care Compare)

5201 Roma Ave NE
Albuquerque, NM 87108-1334
Phone (505) 262-2311

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2006-0332NMMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CS Pacs 3 West LLC CurrentSince Aug 13, 2024 Accepting new patients
NM Pacs 2 LLC CurrentSince Nov 13, 2019 Accepting new patients
New Mexico Pac Services PC CurrentSince Nov 13, 2019 Accepting new patients
St. John Healthcare and Rehabilitation Center, LLC Past Accepting new patients
Peak Medical New Mexico No. 3 LLC Past Accepting new patients

Locations

7208 Jefferson St NE
Albuquerque, NM 87109
Phone (505) 821-1200

7900 Constitution Ave NE
Albuquerque, NM 87110
Phone (505) 296-5565

3025 Terrace Dr
Las Cruces, NM 88011
Phone (575) 522-1362

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rio Rancho CenterRio Rancho, NM, CCN 325033 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Jun 1, 2024
Mar 9, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320364800000",
    "number": "1770622714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 LOMAS BLVD NE",
            "address_2": "MSC 084770",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNM HOSPITAL INTERNAL MEDICINE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-272-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "CHARLESLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2011-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "2006-0332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.