NPIMap

Organization Active NPI

Chrysalis Healthcare LLC

  • Psychiatry Physician
  • Albuquerque, NM
National Provider Identifier
1982219499
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
CHRYSALIS HEALTHCARE LLC
Practice address
2616 Mesilla St NE Ste 3
Albuquerque, NM 87110-3659
Phone
(505) 503-6300
NPI assigned
Sep 11, 2020
Last updated
Aug 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Authorized official

Name
Justin Beatty, MDNPI 1013303981
Title
Owner
Phone
(505) 808-9454

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
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

2616 Mesilla St NE Ste 3
Albuquerque, NM 87110-3659

Mailing address

2632 Mesilla St NE Ste 6
Albuquerque, NM 87110-3614
Phone (505) 259-2431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201028001924 NM Part B Supplier - Clinic/Group Practice 6204246580 Receives reassigned benefits from 11 practitioners
Practice locations: Albuquerque, NM

National Provider Directory

National Provider Directory

Locations

2155 Louisiana Blvd NE
Ste 1200
Albuquerque, NM 87110
Phone (505) 503-6300

2616 Mesilla St NE
Ste 3
Albuquerque, NM 87110
Phone (505) 503-6300

2632 Mesilla St NE
Ste 6
Albuquerque, NM 87110
Phone (505) 259-2431

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1982219499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2632 MESILLA ST NE STE 6",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103614",
            "telephone_number": "505-259-2431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2616 MESILLA ST NE STE 3",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103659",
            "telephone_number": "505-503-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRYSALIS HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-11",
        "last_updated": "2024-08-02",
        "certification_date": "2024-06-26",
        "status": "A",
        "authorized_official_last_name": "BEATTY",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-808-9454",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "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 Aug 2, 2024; 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.