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DR. PRATHIMA GURUGURI MBBS
NPI 1073850251
Internal Medicine in Albuquerque, NM

Active since January 09, 2013PECOS EnrolledAccepts Medicare Assignment
83.84/100
CMS Quality Rating
1100 CENTRAL AVE SE, 4TH FLOOR B, ALBUQUERQUE, NM 87106(505) 724-6124(505) 724-6125 Get Directions Write a Review

NPPES record last updated: March 4, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Prathima Guruguri Mbbs NPPES

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

DR. PRATHIMA GURUGURI MBBS (NPI 1073850251) is an individual internal medicine provider in Albuquerque, New Mexico, licensed in New Mexico (MD2014-0802) and active in the NPI registry since January 2013. She is enrolled in Medicare PECOS, is affiliated with Presbyterian Hospital, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1073850251
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. PRATHIMA GURUGURICredential: MBBS
Location Address1100 CENTRAL AVE SE, 4TH FLOOR BAlbuquerque, NM 87106-4930
Mailing AddressPo Box 26666, Phs Provider EnrollmentAlbuquerque, NM 87125-6666 · (505) 923-6770 · Fax (505) 923-5354
Phone(505) 724-6124
Fax(505) 724-6125
Sole ProprietorNo
Medical School CMSOtherGraduated 2008
Enumeration DateJanuary 9, 2013
Last NPPES UpdateMarch 4, 2016
✔ NPI 1073850251 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NM · MD2014-0802
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1100 CENTRAL AVE SE, Albuquerque, NM 87106
Open in Google Maps ↗

Other Identifiers 2

Medicare PIN424185YS5YNM
Medicaid69277851NM

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. Prathima Guruguri Mbbs 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 ID6406076157
PECOS Enrollment IDI20150730010817
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 5

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

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.
294 services115 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
109 services105 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
66 services34 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
20 services20 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
18 services18 patients

Hospital Affiliations CMS Care Compare

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

Presbyterian Hospital

Acute Care Hospitals · Albuquerque, NM
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number320021
Location1100 Central Avenue SEAlbuquerque, NM 87106 · Bernalillo County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 87106 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
$126.21 typical visit price
range $54.26 – $166.80
Typical copayment $31.55 (range $13.56 – $41.70)
Most-billed visit code 99204
Established Patient
$96.38 typical visit price
range $17.00 – $135.35
Typical copayment $24.09 (range $4.25 – $33.83)
Most-billed visit code 99214
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.

83.84/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality84.59
Promoting Interoperability100
Improvement Activities40
Cost58.63

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
3 suppliers15 claims15 services$15.13 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
4 suppliers13 claims13 services$67.83 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

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

AUDRA DAWN CLEMENS PA-C
Physician Assistant
1100 CENTRAL AVE SE
ALBUQUERQUE, NM 87106
Bernalillo County (505) 724-6124
STEFANIE LEIGH RAITT PHARMD, PHC
Pharmacist (Pharmacotherapy)
1100 CENTRAL AVE SE
ALBUQUERQUE, NM 87106
Bernalillo County (505) 681-4154
SARAH VERTREES D.O.
Pediatrics
1100 CENTRAL AVE SE, PMG PEDIATRIC URGENT CARE
ALBUQUERQUE, NM 87106
Bernalillo County (505) 841-1819
NICHOLAS WEISS D.O.
Emergency Medicine
1100 CENTRAL AVE SE, EMERGENCY MEDICINE
ALBUQUERQUE, NM 87106
Bernalillo County (505) 841-1125
LUKE EZEKIEL GLAZENER PA-C
Physician Assistant
1100 CENTRAL AVE SE
ALBUQUERQUE, NM 87106
Bernalillo County (505) 841-1125
SARAH LEW
Student in an Organized Health Care Education/Training Program
1100 CENTRAL AVE SE
ALBUQUERQUE, NM 87106
Bernalillo County (505) 841-1234
NATALEE TRUEBA CCHW
Community Health Worker
1100 CENTRAL AVE SE
ALBUQUERQUE, NM 87106
Bernalillo County (505) 554-8161
PATRICIA HERSON C.R.N.P.
Nurse Practitioner (Gerontology)
1100 CENTRAL AVE SE, PALLIATIVE CARE
ALBUQUERQUE, NM 87106
Bernalillo County (505) 252-7393

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prathima Guruguri's NPI number?

The NPI number for Prathima Guruguri is 1073850251. It was assigned to this individual provider in the NPPES registry on January 9, 2013.

Where is Prathima Guruguri located?

Prathima Guruguri practices at 1100 Central Ave SE 4th Floor B, Albuquerque, NM 87106. The listed phone number is (505) 724-6124.

What is Prathima Guruguri's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Prathima Guruguri enrolled in Medicare?

Yes. Prathima Guruguri is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Prathima Guruguri affiliated with any hospitals?

According to CMS data, Prathima Guruguri is affiliated with Presbyterian Hospital.

When was this NPI record last updated?

The NPPES record for Prathima Guruguri was last updated on March 4, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.