Individual provider Active NPI

Gustavo Barrazueta, M.D.

  • Orthopaedic Surgery Physician
  • Carlsbad, NM
National Provider Identifier
1154701670
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD2024-0466 Issued in NM
Practice address
2402 W Pierce St Ste 6E
Carlsbad, NM 88220-3566
Phone
(575) 628-0312
Fax
(575) 628-8015
NPI assigned
Jun 1, 2015
Last updated
Jun 7, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 264108 MA
Orthopaedic Surgery Physician 207X00000X 35.142413 OH
Orthopaedic Surgery Physician 207X00000X MD2024-0466 NM Primary

Addresses

Primary practice location

2402 W Pierce St Ste 6E
Carlsbad, NM 88220-3566

Mailing address

2402 W Pierce St Ste 6E
Carlsbad, NM 88220-3566
Phone (575) 628-0312

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gustavo.barrazueta.1@1739.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, NM, MS3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20231116001118 AZ Practitioner - Orthopedic Surgery 7012212756
I20240521000921 NM Practitioner - Orthopedic Surgery 7012212756 Reassigns benefits to 1 organization
I20260120001391 MS Practitioner - Orthopedic Surgery 7012212756 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vicksburg Clinic LLCGroup PAC ID 5890696330, 27 clinicians
Pecos Valley of New Mexico LLCGroup PAC ID 2466359781, 33 clinicians

Practice addresses (Care Compare)

2200 Hwy 61 N
Suite 1400
Vicksburg, MS 39183-8246
Phone (601) 883-3391

2402 W Pierce St
Carlsbad, NM 88220-3566

2420 W Pierce St
Carlsbad, NM 88220-3518

2430 W Pierce St
Carlsbad, NM 88220-3553
Phone (575) 885-0995

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.53 of 100Reported as apm
Quality
79.07
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement1-10
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)27
Removal of tissue11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
264108MAMDOrthopaedic Surgery Physician
MD2024-0466NMMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vicksburg Clinic LLC CurrentSince Jan 9, 2026 Accepting new patients
Pecos Valley of New Mexico, LLC CurrentSince Jun 1, 2024 Accepting new patients

Locations

104 McAuley Dr
Vicksburg, MS 39183
Phone (601) 638-7271

2200 Highway 61 N
Ste 1400
Vicksburg, MS 39183
Phone (601) 883-3391

2402 W Pierce St
Ste 6E
Carlsbad, NM 88220
Phone (505) 885-0995

2420 W Pierce St
Ste 200
Carlsbad, NM 88220
Phone (505) 885-0600

Interoperability endpoints

  • Direct secure messaging: gustavo.barrazueta.1@1739.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1154701670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2402 W PIERCE ST STE 6E",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882203566",
            "telephone_number": "575-628-0312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 W PIERCE ST STE 6E",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882203566",
            "telephone_number": "575-628-0312",
            "fax_number": "575-628-8015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRAZUETA",
        "first_name": "GUSTAVO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-01",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MA",
            "license": "264108",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "35.142413",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NM",
            "license": "MD2024-0466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gustavo.barrazueta.1@1739.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "2402 W Pierce St Ste 6E",
            "city": "Carlsbad",
            "state": "NM",
            "country_code": "US",
            "postal_code": "882203566",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carlsbad, NM

Sources for this page

Verify at the official NPI Registry.