Individual provider Active NPI

Edith R. Gurrola, MD, MPP

  • Emergency Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1700141157
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD2017-0464 Issued in NM
Practice address
1100 Central Ave SE
Albuquerque, NM 87106-4930
Phone
(505) 841-1125
Fax
(505) 841-1737
NPI assigned
Jul 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X R73247 AZ
Emergency Medicine Physician 207P00000X MD2017-0464 NM Primary

Addresses

Primary practice location

1100 Central Ave SE
Albuquerque, NM 87106-4930

Mailing address

751 South Bascom Avenue
Department of Emergency Medicine
San Jose, CA 95128
Phone (408) 885-5111

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
I20170824003275 NM Practitioner - Emergency Medicine 2567746944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R73247AZMDEmergency Medicine Physician
MD2017-0464NMMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Emergency Medicine CurrentSince Aug 14, 2017 Accepting new patients
Presbyterian Healthcare Services Current Accepting new patients

Locations

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

8300 Constitution Ave NE
Bldg D
Albuquerque, NM 87110
Phone (505) 291-2200

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

Interoperability endpoints

  • Direct secure messaging: egurrola109003@direct.phs.org

Organizations & group practices 2

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": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1700141157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 SOUTH BASCOM AVENUE",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95128",
            "telephone_number": "408-885-5111",
            "fax_number": "408-885-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CENTRAL AVE SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064930",
            "telephone_number": "505-841-1125",
            "fax_number": "505-841-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURROLA",
        "first_name": "EDITH",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "MD, MPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "R73247",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "MD2017-0464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.