Individual provider Active NPI

Craig K Gilcrease, PA-C

  • Surgical Physician Assistant
  • Albuquerque, NM
National Provider Identifier
1265581185
Registry record updated Aug 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA2003-0047 Issued in NM
Practice address
502 Elm St NE
Albuquerque, NM 87102-2512
Phone
(505) 841-1000
Fax
(505) 843-2592
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA2003-0047 NM Primary

Addresses

Primary practice location

502 Elm St NE
Albuquerque, NM 87102-2512

Mailing address

502 Elm St NE
Albuquerque, NM 87102-2512
Phone (505) 841-1000

Other identifiers 2

IdentifierTypeStateIssuer
P00428450OtherAZRAILROAD MEDICARE
223634MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040419000268 NM Practitioner - Physician Assistant 6608861729 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Medical Associates, LLCGroup PAC ID 7214831114, 326 clinicians

Practice addresses (Care Compare)

4701 Montgomery Blvd NE
Albuquerque, NM 87109-1219
Phone (505) 727-7800

601 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3619
Phone (505) 727-8000

715 Dr Martin Luther King Jr Ave NE
Suite 301
Albuquerque, NM 87102-3668
Phone (505) 727-7090

Hospital & facility affiliations

  • Lovelace Medical Center Hospital, Albuquerque, NM, CCN 320009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3642AZMDGeneral Practice Dentistry
PA2003-0047NMMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince Dec 1, 2019 Accepting new patients
Presbyterian Healthcare Services CurrentSince Jun 27, 2012 Accepting new patients
Presbyterian Healthcare Services CurrentSince Jun 27, 2012 Accepting new patients
Milagro Medical Group PC Past Accepting new patients

Locations

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

502 Elm St NE
Albuquerque, NM 87102

504 Elm St NE
Albuquerque, NM 87102
Phone (505) 724-2000

4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

Interoperability endpoints

  • Direct secure messaging: cgilcrease278873@ahs.direct-ci.com

Organizations & group practices 4

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 1

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406851200000",
    "number": "1265581185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 ELM ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022512",
            "telephone_number": "505-841-1000",
            "fax_number": "505-843-2956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 ELM ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022512",
            "telephone_number": "505-841-1000",
            "fax_number": "505-843-2592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILCREASE",
        "first_name": "CRAIG",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2014-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NM",
            "license": "PA2003-0047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00428450",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "223634",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.