DAVITA MEDICAL GROUP – NPI #1124053210
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Health Care Provider Taxonomy Code for Family Medicine

DAVITA MEDICAL GROUP is a provider located in ALBUQUERQUE, NM. NPPES has assigned the NPI number 1124053210 to DAVITA MEDICAL GROUP on July 11, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “DAVITA MEDICAL GROUP” is a dba name, the actual legal business name for this organization is OPTUMCARE NEW MEXICO LLC. The primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 2 years ago on Mar 29, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for DAVITA MEDICAL GROUP below.

NPI Profile for
OPTUMCARE NEW MEXICO LLC

NPI Number
1124053210
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
OPTUMCARE NEW MEXICO LLC
Doing Business As (dba): DAVITA MEDICAL GROUP
Primary location
2901 TRANSPORT ST SE
ALBUQUERQUE, NM 87106-4382
Phone: (505) 262-7000 Fax: (505) 262-7652
Mailing address
PO BOX 26028
ALBUQUERQUE, NM 87125-6028
Phone: (505) 262-7000 Fax: (505) 262-7652
Organization Subpart
No
Authorized Official
EMILY CASTILLO
ASSOCIATE DIRECTOR
Phone: (702) 480-2550
Updated
Certification Date
Mar 29, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)		 NM 32D0685327

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.