Individual provider Active NPI

Thomas Gladson Grace, M.D.

  • Specialist
  • Albuquerque, NM
National Provider Identifier
1376661371
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
NM 77-38 Issued in NM
Practice address
8301 Spain Rd NE
Albuquerque, NM 87109-3166
Phone
(505) 821-6663
Fax
(505) 823-2683
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NM 77-38 NM Primary

Addresses

Primary practice location

8301 Spain Rd NE
Albuquerque, NM 87109-3166

Mailing address

8301 Spain Rd NE
Albuquerque, NM 87109-3166
Phone (505) 821-6663

Other identifiers 2

IdentifierTypeStateIssuer
00016071MedicaidNM
NM007588OtherNMBC/BS OF NM

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
I20040324001318 NM Practitioner - Orthopedic Surgery 5092606236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Tulane University School of Medicine, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Academy Orthopaedic Clinic LLCGroup PAC ID 3375700966, 2 clinicians

Practice addresses (Care Compare)

8301 Spain Rd NE
Albuquerque, NM 87109-3166
Phone (505) 821-6663

Hospital & facility affiliations

  • Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NM 77-38NMMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Academy Orthopaedic Clinic LLC Specialist CurrentSince May 1, 2001 Accepting new patients

Locations

8301 Spain Rd NE
Albuquerque, NM 87109
Phone (505) 821-6663

Organizations & group practices 1

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 2

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197244800000",
    "number": "1376661371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301 SPAIN RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093166",
            "telephone_number": "505-821-6663",
            "fax_number": "505-823-2683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301 SPAIN RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093166",
            "telephone_number": "505-821-6663",
            "fax_number": "505-823-2683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "THOMAS",
        "middle_name": "GLADSON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NM",
            "license": "NM 77-38",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00016071",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF NM",
            "identifier": "NM007588",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.