Active NPI
Craig K Gilcrease, PA-C
- Surgical Physician Assistant
- Albuquerque, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- PA2003-0047
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00428450 | Other | AZ | RAILROAD MEDICARE |
| 223634 | Medicaid | AZ |
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
Enrollment records 1
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
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3642 | AZ | MD | General Practice Dentistry |
| PA2003-0047 | NM | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Medical Associates, LLC | Current | Accepting new patients | |
| Presbyterian Healthcare Services | Current | Accepting new patients | |
| Presbyterian Healthcare Services | Current | 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
- 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.
-
- General Practice Physician
- Albuquerque, NM
- NPI 1164491072
-
- Internal Medicine Physician
- Albuquerque, NM
- NPI 1104802354
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1215913470
-
- Hospitalist Physician
- Albuquerque, NM
- NPI 1548265713
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1306914213
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.