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SUMMIT EMERGENCY MEDICINE LLC
NPI 1679112130
Emergency Medicine in Las Vegas, NM

Active since January 02, 2020
104 LEGION DR, LAS VEGAS, NM 87701(505) 426-3930 Get Directions Write a Review

NPPES record last updated: January 2, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Summit Emergency Medicine Llc NPPES

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

SUMMIT EMERGENCY MEDICINE LLC (NPI 1679112130) is a healthcare organization registered as an emergency medicine in Las Vegas, New Mexico and active in the NPI registry since January 2020. The organization lists Caleb O'rear, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1679112130
Entity TypeOrganization
Primary Taxonomy207P00000X
Legal Business NameSUMMIT EMERGENCY MEDICINE LLC
Location Address104 LEGION DRLas Vegas, NM 87701-4804
Mailing Address104 Legion DrLas Vegas, NM 87701-4804
Phone(505) 426-3930
Organization SubpartNo
Authorized OfficialCaleb O'rearAuthorized Official · (505) 426-3930
Enumeration DateJanuary 2, 2020
✔ NPI 1679112130 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
104 LEGION DR, Las Vegas, NM 87701
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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)

Summit Emergency Medicine Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

14

Medicare enrollment records show 14 clinicians reassign Medicare billing to Summit Emergency Medicine LLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 3

Family Practice8
Emergency Medicine5
Nurse Practitioner1

Clinicians, nearest first (14)

Allan Herman, MD
Family Practice
NPI 1326604851
104 LEGION DR
Las Vegas, NM 87701
(505) 426-3504
✔ PECOS✔ Accepts Medicare0.1 mi
Jesus Tafoya, M.D.
Family Practice
NPI 1992118145
2515 RIDGE RUNNER RD
Las Vegas, NM 87701
(505) 434-0119
✔ PECOS✔ Accepts Medicare0.6 mi
David Phillips, MD
Family Practice
NPI 1720576887
117 CAMINO DE VIDA STE 300
Santa Rosa, NM 88435
(575) 472-4311
✔ PECOS✔ Accepts Medicare56 mi
James Gonzales, MD
Family Practice
NPI 1730507955
12208 MIRANDY CT NE
Albuquerque, NM 87122
(505) 554-4579
✔ PECOS✔ Accepts Medicare79 mi
Patrick Craddock, MD
Emergency Medicine
NPI 1477518710
1100 CENTRAL AVE SE
Albuquerque, NM 87106
(505) 841-1125
✔ PECOS✔ Accepts Medicare88 mi
Kelly Lopez, FPN
Nurse Practitioner
NPI 1861855785
320 N MAIN ST
Belen, NM 87002
(505) 361-1167
✔ PECOS✔ Accepts Medicare110 mi
Colin Henderson, MD
Family Practice
NPI 1982720348
19021 HWY 285 CONEJOS COUNTY HOSPITAL
La Jara, CO 81140
(719) 274-5121
✔ PECOS✔ Accepts Medicare121 mi
Michael Stephens, M.D.
Emergency Medicine
NPI 1639128606
405 W COUNTRY CLUB RD
Roswell, NM 88201
(505) 622-2714
✔ PECOS✔ Accepts Medicare157 mi
Ralph Holsworth, D.O.
Emergency Medicine
NPI 1881654150
373 E 10TH AVE
Springfield, CO 81073
(719) 523-6628
✔ PECOS✔ Accepts Medicare190 mi
David Alcindor, M.D.
Family Practice
NPI 1609863000
57950 LEAVENWORTH ST 22 MDG SGQ
Mcconnell Afb, KS 67221
(316) 759-5864
✔ PECOS✔ Accepts Medicare464 mi
Eugene Gicheru, MD
Emergency Medicine
NPI 1134144132
4500 S LANCASTER RD
Dallas, TX 75216
(214) 742-8387
✔ PECOS523 mi
Asuquo Esuabana, MD
Family Practice
NPI 1710096615
723 MEMORIAL ST
Prosser, WA 99350
(509) 786-2307
✔ PECOS✔ Accepts Medicare1,052 mi
Mark Bolton, M.D.
Family Practice
NPI 1790785152
420 N JAMES RD
Columbus, OH 43219
(614) 257-5000
✔ PECOS✔ Accepts Medicare1,254 mi
Karl Unkenholz, M.D.
Emergency Medicine
NPI 1215914429
50 LEROY ST
Potsdam, NY 13676
(315) 265-3300
✔ PECOS✔ Accepts Medicare1,706 mi

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 Summit Emergency Medicine LLC's NPI number?

The NPI number for Summit Emergency Medicine LLC is 1679112130. It was assigned to this organization in the NPPES registry on January 2, 2020.

Where is Summit Emergency Medicine LLC located?

Summit Emergency Medicine LLC is located at 104 Legion Dr, Las Vegas, NM 87701. The listed phone number is (505) 426-3930.

What is Summit Emergency Medicine LLC's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Summit Emergency Medicine LLC enrolled in Medicare?

Yes. Summit Emergency Medicine LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Summit Emergency Medicine LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 14 clinicians in 3 Medicare specialties reassign their Medicare billing to Summit Emergency Medicine 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 Family Practice (8), Emergency Medicine (5) and Nurse Practitioner (1). Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Summit Emergency Medicine LLC was last updated on January 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.