Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Omni Medical Group LLC

Organization Sports Medicine (Neuromusculoskeletal Medicine) Physician · NPI 1568768042

Omni Medical Group LLC provides Sports Medicine (Neuromusculoskeletal Medicine) Physician services in Albuquerque, New Mexico. Licensed in New Mexico. Registered with an NPI since 2011.

Licensed in
NM
In the registry since
2011
Specialties on file
4
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4201 Central Ave NW K3
Albuquerque, NM 87105-1630 Not confirmed with CMS for 11 years — call before visiting
Phone: (505) 717-1685
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician Taxonomy 204C00000X · Licence 6556 (NM)
Family Medicine Physician Taxonomy 207Q00000X
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA20030032 (NM)

Record details

NPI number1568768042
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Olena Dziuba — Cfo · (505) 573-2495
Other names Clinica La Esperanza
NPI enumeratedFebruary 1, 2011
Last updated in NPPESJanuary 19, 2015
Mailing address4201 Central Ave Nw, Ste K3, Albuquerque, NM 87105-1630

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