Active NPI
Bradley John Espeseth, NP-C
- Family Nurse Practitioner
- Gallup, NM
National Provider Identifier
1740463876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- CNP-03469
- Practice address
- 516 E Nizhoni Blvd
Gallup, NM 87301-5748 - Phone
- (505) 722-1000
- NPI assigned
- Dec 12, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R60407 | NM | |
| Family Nurse Practitioner | 363LF0000X | CNP-03469 | NM | Primary |
Addresses
Primary practice location
516 E Nizhoni Blvd
Gallup, NM 87301-5748
Mailing address
PO Box 130
San Fidel, NM 87049-0130
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, NM
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 88.68 of 100
- Quality
- 82.35
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.6
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R60407 | NM | MD | Registered Nurse |
| CNP-03469 | NM | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presbyterian Healthcare Services | Current | Accepting new patients | |
| Presbyterian Healthcare Services | Current | Accepting new patients | |
| DHHS,PHS,Naihs, Gallup Indian Medical Center | Current | Accepting new patients | |
| Presbyterian Healthcare Services | Past | Accepting new patients |
Locations
8100 Constitution Pl NE
Ste 400
Albuquerque, NM 87110
Phone (505) 559-1122
2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577
516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326
Interoperability endpoints
- bespeseth201484@direct.phs.org
Organizations & group practices 4
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.
-
- General Acute Care Hospital
- Gallup, NM
- NPI 1225002322
TX
-
dba Presbyterian Medical Group
- Internal Medicine Physician
- Albuquerque, NM
- NPI 1104802354
-
dba Presbyterian Hospital
- General Acute Care Hospital
- Albuquerque, NM
- NPI 1215913470
-
dba Espanola Hospital
- Rural Acute Care Hospital
- Espanola, NM
- NPI 1154307593
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541462400000",
"number": "1740463876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 130",
"city": "SAN FIDEL",
"state": "NM",
"postal_code": "870490130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 E NIZHONI BLVD",
"city": "GALLUP",
"state": "NM",
"postal_code": "873015748",
"telephone_number": "505-722-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESPESETH",
"first_name": "BRADLEY",
"middle_name": "JOHN",
"name_prefix": "Mr.",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-12",
"last_updated": "2018-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NM",
"license": "R60407",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NM",
"license": "CNP-03469",
"primary": true
}
],
"identifiers": [],
"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 Nov 6, 2018; 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.