Individual provider Active NPI

Antoine Jakiche, M.D.

  • Gastroenterology Physician
  • Albuquerque, NM
National Provider Identifier
1609875996
Registry record updated Sep 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
2002-0052 Issued in NM
Practice address
7788 Jefferson St NE
Albuquerque, NM 87109-4342
Phone
(505) 999-1600
Fax
(505) 999-1651
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 2002-0052 NM Primary

Addresses

Primary practice location

7788 Jefferson St NE
Albuquerque, NM 87109-4342

Mailing address

7788 Jefferson St NE
Albuquerque, NM 87109-4342
Phone (505) 999-1600

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
I20040510001468 NM Practitioner - Gastroenterology 6204825631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Gastroenterology AssociatesGroup PAC ID 2062316086, 27 clinicians

Practice addresses (Care Compare)

7788 Jefferson St NE
Albuquerque, NM 87109-4342
Phone (505) 999-1600

Hospital & facility affiliations

  • Lovelace Medical Center Hospital, Albuquerque, NM, CCN 320009
  • Unm Hospital Hospital, Albuquerque, NM, CCN 320001

Merit-based Incentive Payment System (MIPS)

Final score
84.34 of 100Reported as group
Quality
77.27
Promoting interoperability
100
Improvement activities
40
Cost
70.54

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy91
Upper gastrointestinal (GI) endoscopy for acid reflux117

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Gastroenterology Associates CurrentSince Jan 3, 2005 Accepting new patients
Taos Health Systems, Inc., Holy Cross Hospital Past Accepting new patients
Southwest Endoscopy LTD PastSince Apr 30, 2003 Accepting new patients

Locations

7788 Jefferson St NE
Albuquerque, NM 87109
Phone (505) 999-1600

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12517/brand/1/csg/1/fhir/r4
  • Direct secure messaging: antoine.jakiche.1@12517.direct.athenahealth.com

Organizations & group practices 3

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 3

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283299200000",
    "number": "1609875996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7788 JEFFERSON ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094342",
            "telephone_number": "505-999-1600",
            "fax_number": "505-999-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7788 JEFFERSON ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094342",
            "telephone_number": "505-999-1600",
            "fax_number": "505-999-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAKICHE",
        "first_name": "ANTOINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2010-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NM",
            "license": "2002-0052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.