Active NPI
Maria Ynes Brueckner, M.D.
- Cardiovascular Disease Physician
- Gallup, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 32304
- Practice address
- 516 East Nizhoni Blvd.
Gallup, NM 87301 - Phone
- (505) 722-1000
- Fax
- (505) 726-8557
- NPI assigned
- May 22, 2006
- Last updated
- Sep 3, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 32304 | AZ | Primary |
Addresses
Primary practice location
516 East Nizhoni Blvd.
Gallup, NM 87301
Mailing address
P.O. Box 1337
Gallup, NM 87305-1337
Phone (505) 722-1000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 817710 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- 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
- Internal Medicine
- Education
- Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
516 E Nizhoni Blvd
Gallup, NM 87301-5748
Phone (505) 722-1000
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 78.18 of 100
- Quality
- 61.12
- Improvement activities
- 40
- Cost
- 81.87
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32304 | AZ | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DHHS,PHS,Naihs, Gallup Indian Medical Center | Current | Accepting new patients | |
| Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm | Past | Accepting new patients | |
| DHHS PHS Naihs Fort Defiance Hospital | Past | Accepting new patients |
Locations
516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Acute Care Hospital
- Gallup, NM
- NPI 1225002322
TX
-
dba Ak-Chin Clinic
- Public Health or Welfare Agency
- Maricopa, AZ
- NPI 1538043443
-
dba PHS Fort Defiance Indian Hospital
- General Acute Care Hospital
- Fort Defiance, AZ
- NPI 1700962131
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1306914213
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283472000000",
"number": "1629022678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 1337",
"city": "GALLUP",
"state": "NM",
"postal_code": "873051337",
"telephone_number": "505-722-1000",
"fax_number": "505-726-8557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 EAST NIZHONI BLVD.",
"city": "GALLUP",
"state": "NM",
"postal_code": "87301",
"telephone_number": "505-722-1000",
"fax_number": "505-726-8557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUECKNER",
"first_name": "MARIA",
"middle_name": "YNES",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-22",
"last_updated": "2010-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "AZ",
"license": "32304",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "817710",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gallup, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2010; 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.