Individual provider Active NPI

Richard Jerome Wilkerson, MD

  • Vascular Surgery Physician
  • Albuquerque, NM
National Provider Identifier
1376519488
Registry record updated Apr 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD2014-0991 Issued in NM
Practice address
502 Elm St NE
Albuquerque, NM 87102-2512
Phone
(505) 841-1000
Fax
(505) 843-2592
NPI assigned
Feb 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X D0062101 MD
Vascular Surgery Physician 2086S0129X K9455 TX
Vascular Surgery Physician 2086S0129X MD2014-0991 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

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150505000503 NM Practitioner - Vascular SurgeryPractitioner - General Surgery 7214996099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
University of Alabama School of Medicine, 1997
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)

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

Hospital & facility affiliations

  • Lovelace Medical Center Hospital, Albuquerque, NM, CCN 320009
  • Lovelace Women'S Hospital Hospital, Albuquerque, NM, CCN 320017
  • Lovelace Westside Hospital Hospital, Albuquerque, NM, CCN 320074
  • Christus St Vincent Regional Medical Center Hospital, Santa Fe, NM, CCN 320002
  • Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Leg revascularization (restoring blood flow)29
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0062101MDMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince May 1, 2019 Accepting new patients
Southwest Medical Associates, LLC CurrentSince May 1, 2019 Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients
Vascular Specialty Services, LLC Vascular Surgery Past Accepting new patients

Locations

502 Elm St NE
Albuquerque, NM 87102

6701 Jefferson St NE
Albuquerque, NM 87109
Phone (505) 727-0600

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

2085 S Pacheco St
Santa Fe, NM 87505
Phone (505) 395-3000

Interoperability endpoints

  • Direct secure messaging: rwilkerson11870@ahs.direct-ci.com
  • Direct secure messaging: dmcrwilke@yourcarecommunity.org
  • Direct secure messaging: richard.wilkerson.1@10534.direct.athenahealth.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 6

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": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428883200000",
    "number": "1376519488",
    "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": "WILKERSON",
        "first_name": "RICHARD",
        "middle_name": "JEROME",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-28",
        "last_updated": "2015-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MD",
            "license": "D0062101",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TX",
            "license": "K9455",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NM",
            "license": "MD2014-0991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.