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BACK AND NECK MEDICAL CARE CENTER, LLC
NPI 1417530304
Clinic/Center - Medical Specialty in Las Cruces, NM

Active since April 29, 2021
2803 DORAL CT, LAS CRUCES, NM 88011(046) 984-4063(877) 532-2113 Get Directions Write a Review

NPPES record last updated: May 8, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 8, 2024, Jun 3, 2021, Apr 29, 2021 (3 updates tracked since 2021).

About Back And Neck Medical Care Center, Llc NPPES

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

BACK AND NECK MEDICAL CARE CENTER, LLC (NPI 1417530304) is a healthcare organization registered as a medical specialty in Las Cruces, New Mexico and active in the NPI registry since April 2021. The organization lists Glenn J. Waldt, Provider Owner, as its authorized official.

NPPES Registry Identity

NPI1417530304
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameBACK AND NECK MEDICAL CARE CENTER, LLC
Location Address2803 DORAL CTLas Cruces, NM 88011-8616
Mailing Address1180 Commerce Dr Unit 14222Las Cruces, NM 88013-4649 · (505) 695-1227 · Fax (877) 532-2113
Phone(046) 984-4063
Fax(877) 532-2113
Organization SubpartNo
Authorized OfficialGlenn J. WaldtProvider Owner · (505) 695-1227
Enumeration DateApril 29, 2021
Last NPPES UpdateMay 8, 20243 updates tracked since enumeration
NPPES CertifiedMay 8, 2024
✔ NPI 1417530304 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
2803 DORAL CT, Las Cruces, NM 88011
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Back And Neck Medical Care Center, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Back And Neck Medical Care Center, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Glenn Waldt, DO
Pain Management
NPI 1437219698
2803 DORAL CT
Las Cruces, NM 88011
(046) 984-4063
✔ PECOS✔ Accepts MedicareSame address

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

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 Back And Neck Medical Care Center, LLC's NPI number?

The NPI number for Back And Neck Medical Care Center, LLC is 1417530304. It was assigned to this organization in the NPPES registry on April 29, 2021.

Where is Back And Neck Medical Care Center, LLC located?

Back And Neck Medical Care Center, LLC is located at 2803 Doral Ct, Las Cruces, NM 88011. The listed phone number is (046) 984-4063.

What is Back And Neck Medical Care Center, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Is Back And Neck Medical Care Center, LLC enrolled in Medicare?

Yes. Back And Neck Medical Care Center, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Back And Neck Medical Care Center, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Pain Management) reassigns their Medicare billing to Back And Neck Medical Care Center, 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Back And Neck Medical Care Center, LLC was last updated on May 8, 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.