Angela R Dorsey, D.O.

Individual provider Active NPI Family Medicine Physician · Gallup, NM

NPI 1033308341 · NPPES record last updated Feb 1, 2012

Key facts

NPI
1033308341
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
4702 (AZ)
Practice address
516 E Nizhoni Blvd
Gallup, NM 87301-5748
Phone
(505) 722-1000
NPI assigned
Oct 23, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Endocrinology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DHHS,PHS,Naihs, Gallup Indian Medical Center (179 clinicians)

Practice addresses (Care Compare)

516 E Nizhoni Blvd
Gallup, NM 87301-5748
Phone (505) 722-1000

Hospital & facility affiliations

  • Gallup Indian Medical Center Hospital · Gallup, NM · CCN 320061

Merit-based Incentive Payment System (MIPS)

Final score
78.18 of 100 (group)
Quality
61.12
Improvement activities
40
Cost
81.87

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20081017000101 TX Practitioner - Endocrinology 2062570211 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4702AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS,PHS,Naihs, Gallup Indian Medical Center Current
since Jun 9, 2008
Accepting new patients

Locations

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4702 AZ Yes

Addresses

Primary practice location

516 E Nizhoni Blvd
Gallup, NM 87301-5748

Mailing address

PO Box 1337
Gallup, NM 87305-1337
Phone (505) 722-1000

Other identifiers

IdentifierTypeStateIssuer
296736MedicaidAZ
38670577MedicaidNM

Other providers in Gallup, NM

All providers in Gallup, NM · Family Medicine Physician in New Mexico

Sources for this page

Verify at the official NPI Registry.