DR. RICHARD L CONVERSE JR. MD
NPI 1013001486
Internal Medicine - Cardiovascular Disease in Durango, CO

Active since October 03, 2006PECOS EnrolledAccepts Medicare Assignment
88.22/100
CMS Quality Rating
1 MERCADO ST STE 130, DURANGO, CO 81301(970) 247-1120(970) 247-1128 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 7, 2023, Jan 5, 2023 (2 updates tracked since 2023).

About Dr. Richard L Converse Jr. Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. RICHARD L CONVERSE JR. MD (NPI 1013001486) is an individual cardiovascular disease provider in Durango, Colorado, licensed in Colorado (DR.0069901) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS, is affiliated with San Juan Regional Medical Center Inc, and maintains a secondary practice location in Albuquerque.

NPPES Registry Identity

NPI1013001486
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameDR. RICHARD L CONVERSE JR.Credential: MD
Location Address1 MERCADO ST STE 130Durango, CO 81301-7306
Mailing Address1 Mercado St Ste 130Durango, CO 81301-7306 · (970) 247-1120 · Fax (970) 247-1128
Fax(970) 247-1128
Sole ProprietorNo
Medical School CMSJohns Hopkins University School Of MedicineGraduated 1987
Enumeration DateOctober 3, 2006
Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration
NPPES CertifiedMarch 7, 2023
NPI 1013001486 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Licenses Licensed in CO · DR.0069901 Licensed in NM · 20030692
Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

1 MERCADO ST STE 130, Durango, CO 81301

Secondary Practice Location 1

Location 1201 Cedar St SE Ste 7600, PRESBYTERIAN HEART GROUP (PHG)Albuquerque, NM 87106-4921 · Phone (505) 563-2500 · Fax (505) 563-2599

Other Identifiers 2

Medicaid9000212517CO
Medicaid02651858NM

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Richard L Converse Jr. Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4880582006
PECOS Enrollment IDI20230118003072
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 22

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010
A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
1,241 services1,019 patients
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
421 services409 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
280 services223 patients
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018
An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.
105 services103 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
91 services42 patients
Nuclear medicine studies of heart muscle at rest and with stress and spect 78452
Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.
79 services79 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

San Juan Regional Medical Center Inc

Acute Care Hospitals · Farmington, NM
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number320005
Location801 West Maple StreetFarmington, NM 87401 · San Juan County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 81301 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$132.55 typical visit price
range $58.06 – $174.82
Typical copayment $33.13 (range $14.51 – $43.70)
Most-billed visit code 99204
Established Patient
$72.20 typical visit price
range $18.88 – $142.79
Typical copayment $18.05 (range $4.72 – $35.69)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

88.22/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality88.96
Promoting Interoperability81
Improvement Activities40

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine (Cardiovascular Disease)
1 MERCADO ST STE 130
DURANGO, CO 81301
Internal Medicine (Cardiovascular Disease)
1 MERCADO ST STE 130
DURANGO, CO 81301
Nurse Practitioner (Acute Care)
1 MERCADO ST STE 130
DURANGO, CO 81301
Internal Medicine (Interventional Cardiology)
1 MERCADO ST STE 130
DURANGO, CO 81301
Nurse Practitioner (Family)
1 MERCADO ST STE 130
DURANGO, CO 81301
Internal Medicine (Interventional Cardiology)
1 MERCADO ST STE 130
DURANGO, CO 81301
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1 MERCADO ST STE 130
DURANGO, CO 81301
Internal Medicine (Cardiovascular Disease)
1 MERCADO ST STE 130
DURANGO, CO 81301

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1013001486, enumerated as an "individual" on October 03, 2006.

The provider is located at 1 MERCADO ST STE 130 DURANGO, CO 81301 and the phone number is (970) 247-1120.

Internal Medicine with taxonomy code 207RC0000X and a focus in Cardiovascular Disease.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.

Richard Converse is affiliated with: SAN JUAN REGIONAL MEDICAL CENTER INC.