NPIMap

Individual provider Active NPI

Grant Gebhard

  • Ophthalmology Physician
  • Durango, CO
National Provider Identifier
1164817821
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
0062913 Issued in CO
Practice address
1266 Escalante Dr Ste 301
Durango, CO 81303-8934
Phone
(970) 828-2200
Fax
(970) 828-2201
NPI assigned
Mar 31, 2015
Last updated
Jan 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 0062913 CO Primary

Addresses

Primary practice location

1266 Escalante Dr Ste 301
Durango, CO 81303-8934

Mailing address

2300 E 30TH St
Ste N-105
Farmington, NM 87401-8990
Phone (970) 828-2200

Other practice location 1

2300 E 30th St Ste N-105
Farmington, NM 87401-8990
Phone (970) 828-2200

Other practice location 2

111 S Sligo St Ste A
Cortez, CO 81321-2924
Phone (970) 828-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, NM2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190821004794 CO Practitioner - Ophthalmology 8527350602 Reassigns benefits to 1 organization
I20210831003405 NM Practitioner - Ophthalmology 8527350602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Colorado School of Medicine, Aurora, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Eye Consultants PLLCGroup PAC ID 5991118606, 8 clinicians

Practice addresses (Care Compare)

1266 Escalante Dr
Suite 301
Durango, CO 81303-8902
Phone (970) 828-2200

2300 E 30TH St
Suite N 105
Farmington, NM 87401-8990
Phone (970) 828-2200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.57 of 100Reported as group
Quality
100
Improvement activities
40
Cost
71.91

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery443
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0062913COMDOphthalmology Physician

Organizations & group practices 1

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1164817821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 E 30TH ST",
            "address_2": "STE N-105",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874018990",
            "telephone_number": "970-828-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1266 ESCALANTE DR STE 301",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813038934",
            "telephone_number": "970-828-2200",
            "fax_number": "970-828-2201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 E 30th St Ste N-105",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "NM",
            "postal_code": "874018990",
            "country_code": "US",
            "telephone_number": "970-828-2200",
            "fax_number": "970-828-2201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 S Sligo St Ste A",
            "address_purpose": "LOCATION",
            "city": "Cortez",
            "state": "CO",
            "postal_code": "813212924",
            "country_code": "US",
            "telephone_number": "970-828-2200",
            "fax_number": "970-828-2201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GEBHARD",
        "first_name": "GRANT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-31",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "0062913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

Verify at the official NPI Registry.