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GENEVIVE ACO LLC
NPI 1053200543
Family Medicine - Hospice and Palliative Medicine in Minneapolis, MN

Active since June 30, 2025CLIA 24D2205204 · Waiver
3433 BROADWAY ST NE STE 300, MINNEAPOLIS, MN 55413(763) 587-7737(651) 383-4551 Get Directions Write a Review

NPPES record last updated: June 30, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Genevive Aco Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GENEVIVE ACO LLC (NPI 1053200543) is a healthcare organization registered as a hospice and palliative medicine in Minneapolis, Minnesota and active in the NPI registry since June 2025. The organization holds a CLIA Waiver certificate valid through December 13, 2026 and lists Jennifer Welsh, Chief Medical Officer, as its authorized official.

NPPES Registry Identity

NPI1053200543
Entity TypeOrganization
Primary Taxonomy207QH0002X
Legal Business NameGENEVIVE ACO LLC
Location Address3433 BROADWAY ST NE STE 300Minneapolis, MN 55413-1761
Mailing Address3433 Broadway St Ne Ste 300Minneapolis, MN 55413-1761 · (763) 587-7737 · Fax (651) 383-4551
Phone(763) 587-7737
Fax(651) 383-4551
Organization SubpartNo
Authorized OfficialJennifer WelshChief Medical Officer · (763) 587-7737
Enumeration DateJune 30, 2025
NPPES CertifiedJune 30, 2025
✔ NPI 1053200543 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Hospice and Palliative MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QH0002X
Definition
A family medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care.
3433 BROADWAY ST NE STE 300, Minneapolis, MN 55413
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Genevive Aco Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

44

Medicare enrollment records show 44 clinicians reassign Medicare billing to Genevive Aco LLC, which bills Medicare for the services they deliver. Of these, 43 practice at this address and 44 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 4

Nurse Practitioner33
Family Practice9
Geriatric Medicine1
Internal Medicine1

Nearest to this location (20)

See all 44
Jaclyn Guetzko, DNP, APRN, CNP
Nurse Practitioner
NPI 1275914020
3433 BROADWAY ST NE STE 300
Minneapolis, MN 55413
(763) 587-7737
✔ PECOS✔ Accepts MedicareSame address
Brianna Ngwa, APRN, AGNP
Nurse Practitioner
NPI 1578020525
3433 BROADWAY ST NE STE 300
Minneapolis, MN 55413
(763) 528-3414
✔ PECOS✔ Accepts MedicareSame address
Alissa Abraham, DNP, APRN, AGNP-C
Nurse Practitioner
NPI 1396417572
3433 BROADWAY ST NE STE 300
Minneapolis, MN 55413
(635) 877-7377
✔ PECOS✔ Accepts MedicareSame address
Rita Anderson, NP
Nurse Practitioner
NPI 1609217769
3433 BROADWAY ST NE STE 300
Minneapolis, MN 55413
(763) 587-7737
✔ PECOS✔ Accepts MedicareSame address
Melanie Ashfeld, CNP
Nurse Practitioner
NPI 1669769022
3433 BROADWAY ST NE STE 300
Minneapolis, MN 55413
(763) 587-7737
✔ PECOS✔ Accepts MedicareSame address
Kelli Bronder, APRN,CNP,RN
Nurse Practitioner
NPI 1053073866
3433 BROADWAY ST NE STE 300
Minneapolis, MN 55413
(763) 587-7737
✔ PECOS✔ Accepts MedicareSame address
Cynthia Carlson, MD
Family Practice
NPI 1427035401
3433 BROADWAY ST NE STE 300
Minneapolis, MN 55413
(763) 587-7737
✔ PECOS✔ Accepts MedicareSame address
Momodou Ceesay, GNP
Nurse Practitioner
NPI 1649438417
3433 BROADWAY ST NE STE 300
Minneapolis, MN 55413
(763) 587-7737
✔ PECOS✔ Accepts MedicareSame address
Michaela Cielinski, NURSE PRACTITIONER
Nurse Practitioner
NPI 1801320312
3433 BROADWAY ST NE STE 300
Minneapolis, MN 55413
(763) 587-7737
✔ PECOS✔ Accepts MedicareSame address
Natalie Cowell
Nurse Practitioner
NPI 1003351602
3433 BROADWAY ST NE STE 300
Minneapolis, MN 55413
(763) 587-7737
✔ PECOS✔ Accepts MedicareSame address
Brian Dixon, MD
Internal Medicine
NPI 1528096161
3433 BROADWAY ST NE STE 300
Minneapolis, MN 55413
(763) 587-7737
✔ PECOS✔ Accepts MedicareSame address
Renee Doering, G.N.P
Nurse Practitioner
NPI 1023044484
3433 BROADWAY ST NE STE 300
Minneapolis, MN 55413
(763) 587-7737
✔ PECOS✔ Accepts MedicareSame address
Scott Fairbairn, M.D.
Family Practice
NPI 1174553747
3433 BROADWAY ST NE STE 300
Minneapolis, MN 55413
(763) 587-7737
✔ PECOS✔ Accepts MedicareSame address
William Hamilton, MD
Family Practice
NPI 1194715748
3433 BROADWAY ST NE STE 300
Minneapolis, MN 55413
(763) 587-7737
✔ PECOS✔ Accepts MedicareSame address
Anil Kumar, M.D.
Family Practice
NPI 1740340611
3433 BROADWAY ST NE STE 300
Minneapolis, MN 55413
(763) 587-7737
✔ PECOS✔ Accepts MedicareSame address
Bradley Langley, MD
Family Practice
NPI 1083604722
3433 BROADWAY ST NE STE 300
Minneapolis, MN 55413
(763) 587-7737
✔ PECOS✔ Accepts MedicareSame address
Barry Larson, M.D.
Geriatric Medicine
NPI 1275518631
3433 BROADWAY STREET NE SUITE 300
Minneapolis, MN 55413
(763) 587-7737
✔ PECOS✔ Accepts MedicareSame address
Sarah Maier, MD
Family Practice
NPI 1710953427
3433 BROADWAY ST NE STE 300
Minneapolis, MN 55413
(763) 587-7737
✔ PECOS✔ Accepts MedicareSame address
Kelsi Nelson - Holien, M.D.
Family Practice
NPI 1992733976
3433 BROADWAY ST NE STE 300
Minneapolis, MN 55413
(763) 587-7737
✔ PECOS✔ Accepts MedicareSame address
Jennifer Welsh, MD
Family Practice
NPI 1215045885
3433 BROADWAY ST NE STE 300
Minneapolis, MN 55413
(763) 587-7737
✔ PECOS✔ Accepts MedicareSame address
See all 44 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D2205204

Geriatric Services Of Mn, Dba Genevive · Minneapolis, MN
Active · expires Dec 13, 2026
CLIA Number24D2205204
Laboratory TypePhysician Office
Certificate Effective DateDecember 14, 2024
Certificate Expiration DateDecember 13, 2026
Laboratory DirectorJohn W. Mielke
Laboratory Phone(763) 587-7737
Laboratory LocationGeriatric Services Of Mn, Dba Genevive3433 Broadway Street NE, Ste 300, Minneapolis, MN 55413
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Genevive Aco LLC's NPI number?

The NPI number for Genevive Aco LLC is 1053200543. It was assigned to this organization in the NPPES registry on June 30, 2025.

Where is Genevive Aco LLC located?

Genevive Aco LLC is located at 3433 Broadway St NE Ste 300, Minneapolis, MN 55413. The listed phone number is (763) 587-7737.

What is Genevive Aco LLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Hospice and Palliative Medicine, with taxonomy code 207QH0002X.

Is Genevive Aco LLC enrolled in Medicare?

Yes. Genevive Aco LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Genevive Aco LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 44 clinicians in 4 Medicare specialties reassign their Medicare billing to Genevive Aco LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (33), Family Practice (9) and Geriatric Medicine (1). Of these, 43 practice at this address and 44 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Genevive Aco LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2205204) is associated with this NPI, valid through December 13, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Genevive Aco LLC was last updated on June 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.