Individual provider Active NPI

Peter Tempest, MD

  • Surgery Physician
  • Gallup, NM
National Provider Identifier
1649242348
Registry record updated Feb 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
96-148 Issued in NM
Practice address
516 East Nizhoni Blvd.
Gallup, NM 87301-1337
Phone
(505) 722-1000
Fax
(505) 722-1650
NPI assigned
Feb 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 96-148 NM Primary

Addresses

Primary practice location

516 East Nizhoni Blvd.
Gallup, NM 87301-1337

Mailing address

PO Box 1337
Gallup, NM 87305-1337
Phone (505) 722-1000

Other identifiers 8

IdentifierTypeStateIssuer
020031895OtherRAILROAD MEDICARE
201009894OtherNMPRESBYTERIAN HEALTH/SALUD
85031326887301A096OtherCHAMPUS
NM002030OtherNMBCBS
372376MedicaidAZ
10002108OtherNMLOVELACE HEALTH/SALUD
L8841MedicaidNM
PROVP16408OtherMOLINA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140311000401 TX Practitioner - General Surgery 5991758278 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Dec 30, 2013 Accepting new patients

Locations

1901 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-7000

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

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.

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393459200000",
    "number": "1649242348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1337",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873051337",
            "telephone_number": "505-722-1000",
            "fax_number": "505-722-1650"
        },
        {
            "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": "873011337",
            "telephone_number": "505-722-1000",
            "fax_number": "505-722-1650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEMPEST",
        "first_name": "PETER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2014-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NM",
            "license": "96-148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020031895",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN HEALTH/SALUD",
            "identifier": "201009894",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "85031326887301A096",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NM002030",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "372376",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOVELACE HEALTH/SALUD",
            "identifier": "10002108",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L8841",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "PROVP16408",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

Verify at the official NPI Registry.