Individual provider Active NPI

Gerald Robertson, MD

  • Medical Oncology Physician
  • Gallup, NM
National Provider Identifier
1831161082
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
72-73 Issued in NM
Practice address
Rehoboth McKinley Christian Health Care Services
2111 College Drive
Gallup, NM 87301
Phone
(505) 863-1820
NPI assigned
Feb 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 72-73 NM Primary

Addresses

Primary practice location

Rehoboth McKinley Christian Health Care Services
2111 College Drive
Gallup, NM 87301

Mailing address

Rehoboth McKinley Christian Health Care Services
1901 Red Rock Drive
Gallup, NM 87301
Phone (505) 863-7000

Other identifiers 6

IdentifierTypeStateIssuer
85031326887301A017OtherCHAMPUS
10002106OtherNMLOVELACE HEALTH/SALUD
NM002282OtherNMBCBS
09431MedicaidNM
PROVP15197OtherNMMOLINA
228727MedicaidAZ

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
I20070803000490 NM Practitioner - Internal Medicine 7012008154 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Tufts University School of Medicine, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gallup Community HealthGroup PAC ID 3375926975, 13 clinicians

Practice addresses (Care Compare)

2111 College Dr
Gallup, NM 87301-5600
Phone (505) 397-5172

Hospital & facility affiliations

  • Luna del Valle Hospice, Albuquerque, NM, CCN 321587
  • Rehoboth McKinley Christian Health Care Services Hospital, Gallup, NM, CCN 321313
  • Cibola General Hospital Hospital, Grants, NM, CCN 321308

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72-73NMMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rehoboth McKinley Christian Health Care Services, Inc. Current Accepting new patients
Rehoboth McKinley Christian Health Care Services, Inc CurrentSince Sep 1, 1995 Accepting new patients
Gallup Community Health CurrentSince Nov 1, 2022 Accepting new patients

Locations

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

1900 Red Rock Dr
Gallup, NM 87301
Phone (505) 863-1820

2111 College Dr
Gallup, NM 87301
Phone (505) 397-5172

2022 E Aztec Ave
Gallup, NM 87301
Phone (505) 397-5172

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FBBICD

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.

Hospital & facility affiliations 4

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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1831161082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "REHOBOTH MCKINLEY CHRISTIAN HEALTH CARE SERVICES",
            "address_2": "1901 RED ROCK DRIVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "87301",
            "telephone_number": "505-863-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "REHOBOTH MCKINLEY CHRISTIAN HEALTH CARE SERVICES",
            "address_2": "2111 COLLEGE DRIVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "87301",
            "telephone_number": "505-863-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "GERALD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "NM",
            "license": "72-73",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "85031326887301A017",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOVELACE HEALTH/SALUD",
            "identifier": "10002106",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NM002282",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09431",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "PROVP15197",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "228727",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

Verify at the official NPI Registry.