NPIMap

Individual provider Active NPI

Jessica Terress Evans-Wall, MD

  • Emergency Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1184187114
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD211152 Issued in OR
Practice address
2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone
(505) 272-5062
NPI assigned
Apr 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X M-16625 ID
Student in an Organized Health Care Education/Training Program 390200000X NM
Emergency Medicine Physician 207P00000X MD211152 OR Primary

Addresses

Primary practice location

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719

Mailing address

1 University of New Mexico
Albuquerque, NM 87131-2442
Phone (505) 272-5062

Other practice location 1

1 University Of New Mexico
Albuquerque, NM 87131-2719
Phone (505) 272-5062

Other practice location 2

3325 Pocahontas Rd
Baker City, OR 97814-1464
Phone (541) 523-1797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 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
I20220804000964 ID Practitioner - Emergency Medicine 7911234984 Reassigns benefits to 1 organization
I20220804001189 OR Practitioner - Emergency Medicine 7911234984 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Tufts University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, shared by 18 NPIs, 995 clinicians
Saint Alphonsus Medical Center Baker City IncGroup PAC ID 4981732518, shared by 3 NPIs, 15 clinicians

Practice addresses (Care Compare)

2801 St Anthony Way
Pendleton, OR 97801-3800
Phone (541) 276-5121

3325 Pocahontas Rd
Baker City, OR 97814-1464
Phone (541) 524-2965

4300 E Flamingo Ave
Nampa, ID 83687-3138
Phone (208) 205-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-16625IDMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baker Clinic, LLP Current Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
Saint Alphonsus Medical Center Baker City, Inc CurrentSince Jan 1, 2025 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Sep 1, 2022 Accepting new patients
Cep America, LLC Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
Saint Alphonsus Medical Center Baker City, Inc CurrentSince Jan 1, 2025 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

4300 E Flamingo Ave
Nampa, ID 83687
Phone (208) 205-1000

3325 Pocahontas Rd
Baker City, OR 97814
Phone (541) 523-1797

2801 St Anthony Way
Pendleton, OR 97801
Phone (541) 276-5121

2700 NW Stewart Pkwy
Roseburg, OR 97471
Phone (541) 673-0611

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1523/brand/1/csg/23/fhir/r4
  • Direct secure messaging: jevanswall2011673@direct.trinity-health.org

Organizations & group practices 7

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.

Hospital & facility affiliations 8

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": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1184187114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871312442",
            "telephone_number": "505-272-5062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 LOMAS BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062719",
            "telephone_number": "505-272-5062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 University Of New Mexico",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871312719",
            "country_code": "US",
            "telephone_number": "505-272-5062",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3325 Pocahontas Rd",
            "address_purpose": "LOCATION",
            "city": "Baker City",
            "state": "OR",
            "postal_code": "978141464",
            "country_code": "US",
            "telephone_number": "541-523-1797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS-WALL",
        "first_name": "JESSICA",
        "middle_name": "TERRESS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "M-16625",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD211152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.