William Brant Hesidence II, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

PO2948 Issued in FL

Practice address

511 E Nizhoni Blvd
Gallup, NM 87301-5757

Phone

(505) 722-1000

NPI assigned

Jul 18, 2005

Last updated

Feb 16, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Barry University School of Podiatric Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ryan K Anderson D P M P CGroup PAC ID 7517999121, 51 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

99.91 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: footandanklespecilists.williamhesidence@147936.advancedmd-direct.com
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Ryan K Anderson D P M P C

  dba Foot & Ankle Specialists of Utah

  • Foot & Ankle Surgery Podiatrist
  • Bountiful, UT
  • NPI 1639200215

  NM

  Medicare reassignment Care Compare group NPD
• DHHS PHS Naihs Fort Defiance Hospital

  dba PHS Fort Defiance Indian Hospital

  • General Acute Care Hospital
  • Fort Defiance, AZ
  • NPI 1700962131
  NPD (past)
• KG Health Partners, Inc

  • Podiatrist
  • Clearwater, FL
  • NPI 1487654042
  NPD (past)

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1326047846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 E NIZHONI BLVD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 E NIZHONI BLVD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015757",
            "telephone_number": "505-722-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HESIDENCE",
        "first_name": "WILLIAM",
        "middle_name": "BRANT",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AL",
            "license": "257",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "LA",
            "license": "PD0103",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO 2948",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO2948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Hernandez, LSAA, CHW
• Jemimah Hernandez, RN
• Thomas John Herr, MD
• Laurie Shannon Herrin, RN
• Lauren Michelle Hertzog, PHARMD
• Raquella Hess
• Lucinda Hesuse, DA
• Carl Heuett
• James Murray Hickman, PA-C
• Leann Hickman, RN

• Podiatrist in Gallup, NM
• Providers in Gallup, NM by specialty
• Podiatrist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; 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.

Verify at the official NPI Registry.