1. Home
  2. Directory
  3. New Mexico
  4. Albuquerque
  5. Family Medicine
  6. NPI Profile

DAVITA MEDICAL GROUP
NPI 1124053210
Family Medicine in Albuquerque, NM

Active since July 11, 2006CLIA Certified · 8 labs
2901 TRANSPORT ST SE, ALBUQUERQUE, NM 87106(505) 262-7000(505) 262-7652 Get Directions Write a Review

NPPES record last updated: March 29, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 31, 2020, Aug 19, 2019, Feb 23, 2017 (3 updates tracked since 2017).

About Davita Medical Group NPPES

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

DAVITA MEDICAL GROUP (NPI 1124053210) is a healthcare organization registered as a family medicine in Albuquerque, New Mexico and active in the NPI registry since July 2006. The organization holds 8 active CLIA laboratory certificates and lists Emily Castillo, Associate Director, as its authorized official.

NPPES Registry Identity

NPI1124053210
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameOPTUMCARE NEW MEXICO LLC
Location Address2901 TRANSPORT ST SEAlbuquerque, NM 87106-4382
Mailing AddressPo Box 26028Albuquerque, NM 87125-6028 · (505) 262-7000 · Fax (505) 262-7652
Phone(505) 262-7000
Fax(505) 262-7652
Organization SubpartNo
Authorized OfficialEmily CastilloAssociate Director · (702) 480-2550
Enumeration DateJuly 11, 2006
Last NPPES UpdateMarch 29, 20243 updates tracked since enumeration
NPPES CertifiedMarch 29, 2024
✔ NPI 1124053210 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NM · 32D0685327
Definition
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.
2901 TRANSPORT ST SE, Albuquerque, NM 87106
Open in Google Maps ↗

Other Names 1

Doing Business AsDavita Medical Group

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)

Davita Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

131

Medicare enrollment records show 131 clinicians reassign Medicare billing to Davita Medical Group, which bills Medicare for the services they deliver. Of these, 10 practice at this address and 70 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 12

Nurse Practitioner38
Family Practice33
Diagnostic Radiology29
Internal Medicine15
Cardiovascular Disease (Cardiology)4
Pediatric Medicine4
Ophthalmology2
Rheumatology2
4 other specialties4

Nearest to this location (20)

See all 131
Emma Argueta, CNP
Nurse Practitioner
NPI 1194439943
2901 TRANSPORT ST SE
Albuquerque, NM 87106
(505) 262-3223
✔ PECOS✔ Accepts MedicareSame address
Annmarie Foley, FNP
Nurse Practitioner
NPI 1902221005
2901 TRANSPORT ST SE
Albuquerque, NM 87106
(505) 262-7946
✔ PECOS✔ Accepts MedicareSame address
Nishiena Gandhi, M.D.
Neurology
NPI 1669527438
2901 TRANSPORT ST SE
Albuquerque, NM 87106
(505) 262-7946
✔ PECOS✔ Accepts MedicareSame address
Alicia Pruitt, RN DNP ENP
Nurse Practitioner
NPI 1366436321
2901 TRANSPORT ST SE
Albuquerque, NM 87106
(505) 262-7110
✔ PECOS✔ Accepts MedicareSame address
David Schneider, M.D.
Internal Medicine
NPI 1417046483
2901 TRANSPORT ST SE
Albuquerque, NM 87106
(505) 262-7110
✔ PECOS✔ Accepts MedicareSame address
Deborah Schwartz, MD
Family Practice
NPI 1457707150
2901 TRANSPORT ST SE
Albuquerque, NM 87106
(505) 262-7110
✔ PECOSSame address
Kashmira Singh, MD
Rheumatology
NPI 1194038182
2901 TRANSPORT ST SE
Albuquerque, NM 87106
(505) 262-7248
✔ PECOS✔ Accepts MedicareSame address
Robert Taylor, MD
Cardiovascular Disease (Cardiology)
NPI 1750397360
2901 TRANSPORT ST SE
Albuquerque, NM 87106
(505) 262-7451
✔ PECOS✔ Accepts MedicareSame address
Jaren Trost, M.D.
Rheumatology
NPI 1245617091
2901 TRANSPORT ST SE
Albuquerque, NM 87106
(505) 262-7248
✔ PECOS✔ Accepts MedicareSame address
Ella Webster, MD
Internal Medicine
NPI 1942367982
2901 TRANSPORT ST SE
Albuquerque, NM 87106
(505) 342-8408
✔ PECOS✔ Accepts MedicareSame address
Marizze Lexa Law, AGNP-C
Nurse Practitioner
NPI 1932059300
2901 TRANSPORT ST SE
Albuquerque, NM 87106
(505) 262-7110
✔ PECOS✔ Accepts Medicare0.1 mi
Annette Maxedon, CFNP
Nurse Practitioner
NPI 1306967930
1001 COAL AVE SE
Albuquerque, NM 87106
(505) 843-6168
✔ PECOS✔ Accepts Medicare1.7 mi
Christine Mayes, FNP
Nurse Practitioner
NPI 1891429783
1001 COAL AVE SE
Albuquerque, NM 87106
(505) 843-6168
✔ PECOS✔ Accepts Medicare1.7 mi
Joseph Tran, DO
Internal Medicine
NPI 1790753093
1100 CENTRAL AVE SE INTERNAL MEDICINE, HOSPITALIST
Albuquerque, NM 87106
(505) 724-6124
✔ PECOS✔ Accepts Medicare1.9 mi
Maher Belmamoun, MD
Internal Medicine
NPI 1306847025
500 WALTER ST NE SUITE 309
Albuquerque, NM 87102
(505) 262-3542
✔ PECOS✔ Accepts Medicare2.3 mi
Jean-Paul Dedam, MD
Family Practice
NPI 1649486770
303 ROMA AVE NW
Albuquerque, NM 87102
(505) 262-3542
✔ PECOS2.6 mi
Lara Goss, MD
Internal Medicine
NPI 1316942501
303 ROMA AVE NW
Albuquerque, NM 87102
(505) 262-3542
✔ PECOS✔ Accepts Medicare2.6 mi
Jeremy Gleeson, MD
Endocrinology
NPI 1215960893
5400 GIBSON BLVD SE
Albuquerque, NM 87108
(505) 262-7455
✔ PECOS✔ Accepts Medicare3.1 mi
Lois Moss, NURSE PRACTITIONER
Nurse Practitioner
NPI 1598047706
1821 CARLISLE BLVD NE
Albuquerque, NM 87110
(505) 255-1228
✔ PECOS✔ Accepts Medicare3.7 mi
Michael Montoya, MD
Family Practice
NPI 1215046545
1821 CARLISLE BLVD NE
Albuquerque, NM 87110
(505) 255-1228
✔ PECOS✔ Accepts Medicare3.7 mi
See all 131 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 8

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 32D0685329

Optumcare New Mexico LLC Sunport · Albuquerque, NM
Active · expires Oct 25, 2027
CLIA Number32D0685329
Laboratory TypePhysician Office
Certificate Effective DateOctober 26, 2025
Certificate Expiration DateOctober 25, 2027
Laboratory DirectorDr. Kristy Rinkier
Laboratory Phone(505) 449-3332
Laboratory LocationOptumcare New Mexico LLC Sunport2901 Transport Street SE, Albuquerque, NM 87106
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 32D2020535

Optumcare New Mexico LLC Sunport Center For Pain Management · Albuquerque, NM
Active · expires Feb 21, 2027
CLIA Number32D2020535
Laboratory TypePhysician Office
Certificate Effective DateFebruary 22, 2025
Certificate Expiration DateFebruary 21, 2027
Laboratory DirectorMichael Malizzo
Laboratory Phone(505) 262-7724
Laboratory LocationOptumcare New Mexico LLC Sunport Center For Pain Management2901 Transport Street, Albuquerque, NM 87106
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 32D0685327

Optumcare New Mexico Montgomery Hcc · Albuquerque, NM
Active · expires Aug 14, 2028
CLIA Number32D0685327
Laboratory TypePhysician Office
Certificate Effective DateAugust 15, 2026
Certificate Expiration DateAugust 14, 2028
Laboratory DirectorDr. Donald Ortiz
Laboratory Phone(505) 449-3220
Laboratory LocationOptumcare New Mexico Montgomery Hcc9101 Montgomery Blvd NE, Albuquerque, NM 87111
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 32D0685333

Optumcare New Mexico LLC Coors Hcc · Albuquerque, NM
Active · expires Jan 2, 2028
CLIA Number32D0685333
Laboratory TypePhysician Office
Certificate Effective DateJanuary 3, 2026
Certificate Expiration DateJanuary 2, 2028
Laboratory DirectorKristy Rinkier
Laboratory Phone(505) 702-7998
Laboratory LocationOptumcare New Mexico LLC Coors Hcc2929 Coors Blvd NW, Albuquerque, NM 87120
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 32D0685326

Optumcare New Mexico LLC Juan Tabo North Hcc · Albuquerque, NM
Active · expires Dec 31, 2027
CLIA Number32D0685326
Laboratory TypePhysician Office
Certificate Effective DateJanuary 1, 2026
Certificate Expiration DateDecember 31, 2027
Laboratory DirectorDonald Ortiz
Laboratory Phone(505) 237-8700
Laboratory LocationOptumcare New Mexico LLC Juan Tabo North Hcc2121 Juan Tabo NE, Albuquerque, NM 87112
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 32D1088217

Optumcare New Mexico LLC Midtown · Albuquerque, NM
Active · expires Nov 7, 2027
CLIA Number32D1088217
Laboratory TypePhysician Office
Certificate Effective DateNovember 8, 2025
Certificate Expiration DateNovember 7, 2027
Laboratory DirectorDon J. Ortiz
Laboratory Phone(505) 702-7998
Laboratory LocationOptumcare New Mexico LLC Midtown1821 Carlisle Blvd NE, Albuquerque, NM 87110
CLIA data matches this NPI record on: Name
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 Optumcare New Mexico LLC's NPI number?

The NPI number for Optumcare New Mexico LLC is 1124053210. It was assigned to this organization in the NPPES registry on July 11, 2006. The provider is doing business as Davita Medical Group.

Where is Optumcare New Mexico LLC located?

Optumcare New Mexico LLC is located at 2901 Transport St SE, Albuquerque, NM 87106. The listed phone number is (505) 262-7000.

What is Optumcare New Mexico LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Optumcare New Mexico LLC enrolled in Medicare?

Yes. Optumcare New Mexico LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Optumcare New Mexico LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 131 clinicians in 12 Medicare specialties reassign their Medicare billing to Optumcare New Mexico 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 (38), Family Practice (33) and Diagnostic Radiology (29). Of these, 10 practice at this address and 70 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Optumcare New Mexico LLC hold CLIA laboratory certificates?

Yes. 8 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Optumcare New Mexico LLC was last updated on March 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.