Gilberto Heredia, M.D.
NPI 1649299942 · Family Medicine Physician · Albuquerque, NM
Enrolled with Medicare as Practitioner - Family Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Gilberto Heredia, M.D. is a Family Medicine Physician provider in Albuquerque, NM (NPI 1649299942).
Provider details
- NPI number
- 1649299942
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 98288 (NM)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure25% of score
19 yrs in NPPES registry
- Profile completeness25% of score
100% of core fields populated
- Practice footprint15% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)25% of score
259 Medicare services, 2024 (ranked within specialty)
- Open Payments transparency10% of score
Has Open Payments disclosures (2024)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our .
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More99214 | 151 | $119 |
| Established Patient Office Or Other Outpatient Visit With Low Level OD Decision Making, If Using Time, 20 Minutes Or More99213 | 63 | $86 |
| Hemoglobin A1c Level83036 | 32 | $9 |
| Annual Wellness Visit, Includes a Personalized Prevention Plan of Service (pps), Subsequent VisitG0439 | 13 | $123 |
Typical Medicare-allowed amounts for these services range $9–$123 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 151 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Atorvastatin Calcium | 522 | 161 |
| Levothyroxine Sodium | 452 | 140 |
| Lisinopril | 380 | 115 |
| Gabapentin | 309 | 116 |
| Amlodipine Besylate | 293 | 96 |
| Tamsulosin Hcl | 288 | 95 |
| Hydrocodone/Acetaminophen |
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$723 across 8 records (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-07-18
- Last updated
- 2025-06-12
- Certified
- 2025-06-12
Frequently asked questions
- What is Gilberto Heredia's NPI number?
- Gilberto Heredia's National Provider Identifier (NPI) is 1649299942, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Gilberto Heredia's specialty?
- Gilberto Heredia is listed in the NPPES registry with a primary specialty of Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Gilberto Heredia located?
- Gilberto Heredia's practice location on file with NPPES is 4901 Lang Ave Ne, Albuquerque, NM 87109-4397.
- What is Gilberto Heredia's phone number?
- The practice phone number listed in the NPPES registry for Gilberto Heredia is (505) 842-8171.
- Does Gilberto Heredia accept Medicare?
- Gilberto Heredia is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Gilberto Heredia's NPI active?
- Yes — Gilberto Heredia's NPI (1649299942) is active in the NPPES registry as of the last update on 2025-06-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.