Active NPI
Richard Jerome Wilkerson, MD
- Vascular Surgery Physician
- Albuquerque, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- MD2014-0991
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- University of Alabama School of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
502 Elm St NE
Albuquerque, NM 87102-2512
Phone (505) 841-1000
Hospital & facility affiliations
- Lovelace Medical Center
- Lovelace Women'S Hospital
- Lovelace Westside Hospital
- Christus St Vincent Regional Medical Center
- Presbyterian Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Spinal fusion | 1-10 |
| Leg revascularization (restoring blood flow) | 29 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0062101 | MD | MD | Vascular Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Medical Associates, LLC | Current | Accepting new patients | |
| Southwest Medical Associates, LLC | Current | 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
- rwilkerson11870@ahs.direct-ci.com
- dmcrwilke@yourcarecommunity.org
- 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.
-
- General Practice Physician
- Albuquerque, NM
- NPI 1164491072
-
- Rural Health Clinic/Center
- Roswell, NM
- NPI 1578255253
-
- Critical Access Hospital
- Taos, NM
- NPI 1902338049
-
- Vascular Surgery Physician
- Baltimore, MD
- NPI 1003853706
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1306914213
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1649373887
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1982799375
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1215913470
-
- Psychiatric Hospital Unit
- Albuquerque, NM
- NPI 1598740482
-
- General Acute Care Hospital
- Santa Fe, NM
- NPI 1578587150
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; 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.