Individual provider Active NPI

Oksana Goncharenko, APRN-CNP

  • Gerontology Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1801780937
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
86584 Issued in NM
Practice address
715 Dr Martin Luther King Jr Ave NE Ste 301
Albuquerque, NM 87102-3668
Phone
(505) 727-7090
Fax
(505) 727-9590
NPI assigned
Jun 4, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 86584 NM
Gerontology Nurse Practitioner 363LG0600X 86584 NM Primary
Registered Nurse 163W00000X 751635 NY

Addresses

Primary practice location

715 Dr Martin Luther King Jr Ave NE Ste 301
Albuquerque, NM 87102-3668

Mailing address

4101 Indian School Rd NE Ste 110
Albuquerque, NM 87110-3991
Phone (505) 727-5174

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
I20260130001480 NM Practitioner - Nurse Practitioner 1951889088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Georgetown University School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Medical Associates, LLCGroup PAC ID 7214831114, 326 clinicians

Practice addresses (Care Compare)

715 Dr Martin Luther King Jr Ave NE
Suite 301
Albuquerque, NM 87102-3668
Phone (505) 727-7090

Hospital & facility affiliations

  • Lovelace Medical Center Hospital, Albuquerque, NM, CCN 320009
  • Lovelace Westside Hospital Hospital, Albuquerque, NM, CCN 320074
  • Lovelace Women'S Hospital Hospital, Albuquerque, NM, CCN 320017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
751635NYMDRegistered Nurse
86584NMMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince Jan 1, 2026 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Jan 1, 2026 Accepting new patients

Locations

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360

Organizations & group practices 2

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

Hospital & facility affiliations 3

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": "1748995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1801780937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 INDIAN SCHOOL RD NE STE 110",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103991",
            "telephone_number": "505-727-5174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 DR MARTIN LUTHER KING JR AVE NE STE 301",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023668",
            "telephone_number": "505-727-7090",
            "fax_number": "505-727-9590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONCHARENKO",
        "first_name": "OKSANA",
        "name_prefix": "Ms.",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-04",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "86584",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NM",
            "license": "86584",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "751635",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.