Edison Virgil Etsitty, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

2002-0299 Issued in NM

Practice address

465 Saint Michaels Dr
Suite 202
Santa Fe, NM 87505-7670

Phone

(505) 984-0303

Fax

(505) 984-1116

NPI assigned

Jan 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

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

Specialty

Obstetrics/Gynecology

Education

University of New Mexico School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021

Merit-based Incentive Payment System (MIPS)

Final score

88.68 of 100Reported as group

Quality

82.35

Promoting interoperability

100

Improvement activities

40

Cost

76.6

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eetsitty35093@direct.phs.org

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.

• Presbyterian Healthcare Services

  dba Presbyterian Medical Group

  • Internal Medicine Physician
  • Albuquerque, NM
  • NPI 1104802354

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Presbyterian Healthcare Services

  dba Presbyterian Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470
  NPD
• Presbyterian Healthcare Services

  dba Espanola Hospital

  • Rural Acute Care Hospital
  • Espanola, NM
  • NPI 1154307593
  NPD (past)
• Presbyterian Healthcare Services

  dba Presbyterian Home Healthcare

  • Home Health Agency
  • Albuquerque, NM
  • NPI 1881670214
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Presbyterian Healthcare Services

  dba Presbyterian Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1215913470
  Care Compare affiliation
• Presbyterian Healthcare Services

  dba Presbyterian Kaseman Psych Unit

  • Psychiatric Hospital Unit
  • Albuquerque, NM
  • NPI 1598740482
  Care Compare affiliation

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297296000000",
    "number": "1376521500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 SAINT MICHAELS DR",
            "address_2": "SUITE 202",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057670",
            "telephone_number": "505-984-0303",
            "fax_number": "505-984-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 SAINT MICHAELS DR",
            "address_2": "SUITE 202",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057670",
            "telephone_number": "505-984-0303",
            "fax_number": "505-984-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETSITTY",
        "first_name": "EDISON",
        "middle_name": "VIRGIL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2011-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NM",
            "license": "2002-0299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOVELACE HEALTH/SALUD",
            "identifier": "10003903",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN HEALTH/SALUD",
            "identifier": "201038402",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "723040",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "160058344",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "NM009C04",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50733826",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "PROVP12721",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "850313268020",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Shandale Estrada
• Elizabeth Valerie Estrada, PHARMD
• Misper Etando, PMHNP-BC
• Taylor Jaramillo Etchemendy
• Jan-Carol Etre, RN
• Juliana Eulert, LMFT
• John R Evaldson, M.D.
• Christina E Evans, MA,LPC
• Lily Evans
• Mary Evans, LPCC

• Obstetrics & Gynecology Physician in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Obstetrics & Gynecology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2011; 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.