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EDWIN GILLIAM FP
NPI 1952383143
Nurse Practitioner - Family in Tucson, AZ

Active since November 15, 2005PECOS EnrolledAccepts Medicare Assignment
81.93/100
CMS Quality Rating
1775 E SKYLINE DR, STE 101, TUCSON, AZ 85718(520) 615-6200(520) 615-6255 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Edwin Gilliam Fp NPPES

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

EDWIN GILLIAM FP (NPI 1952383143) is an individual family provider in Tucson, Arizona, licensed in Arizona (RN085103) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS and is a graduate of Other (1997).

NPPES Registry Identity

NPI1952383143
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameEDWIN GILLIAMCredential: FP
Location Address1775 E SKYLINE DR, STE 101Tucson, AZ 85718-1162
Mailing Address1775 E Skyline Dr, Ste 101Tucson, AZ 85718-1162 · (520) 615-6200 · Fax (520) 615-6255
Phone(520) 615-6200
Fax(520) 615-6255
Sole ProprietorNo
Medical School CMSOtherGraduated 1997
Enumeration DateNovember 15, 2005
Last NPPES UpdateJuly 13, 2026
✔ NPI 1952383143 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in AZ · RN085103
1775 E SKYLINE DR, Tucson, AZ 85718
Open in Google Maps ↗

Other Identifiers 1

Medicaid416083AZ

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Edwin Gilliam Fp 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 ID547236416
PECOS Enrollment IDI20040902000908
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Edwin Gilliam reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Sound Physicians Intensivists Of Arizona, Inc
8.0 mi
Internal Medicine
1601 W SAINT MARYS RD
Tucson, AZ 85745
  • Reassigned Medicare billing, Arizona enrollment
  • 66 clinicians in this Medicare group
NPI 1962944702 (520) 872-3000
Tucson Physician Group Holdings, LLC
8.1 mi
Interventional Cardiology
395 N SILVERBELL RD STE 355
Tucson, AZ 85745
  • Reassigned Medicare billing, Arizona enrollment
  • 293 clinicians in this Medicare group
NPI 1356726939 (520) 622-5912
Cogent Healthcare Of Arizona PC
68 mi
Internal Medicine
5700 E HIGHWAY 90
Sierra Vista, AZ 85635
  • Reassigned Medicare billing, Arizona enrollment
  • 372 clinicians in this Medicare group
NPI 1568758266 (520) 417-4594

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

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.

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212
This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.
114 services39 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
47 services38 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.
40 services36 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
30 services30 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85718 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
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.

81.93/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.57
Promoting Interoperability100
Improvement Activities40
Cost60.2

Reported Quality Measures

Controlling High Blood Pressure
81%69 patients4/55-star benchmark: 91%
Dementia: Cognitive Assessment
19%42 patients
Documentation of Current Medications in the Medical Record
98%686 patients4/55-star benchmark: 100%
e-Prescribing
94%465 patients2/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
95%271 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
97%468 patients4/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
87%373 patients4/55-star benchmark: 97%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
31%493 patients3/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 98% · 266 patients
Patients screened: 100% · 266 patients
81%27 patients4/55-star benchmark: 100%
Provide Patients Electronic Access to Their Health Information
84%231 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 14

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

RISE-ANN WOHL MD
Internal Medicine
1775 E SKYLINE DR, STE 175
TUCSON, AZ 85718
Pima County (520) 795-3700
JEAN MARSALLA ANP
Nurse Practitioner (Adult Health)
1775 E SKYLINE DR, STE 101
TUCSON, AZ 85718
Pima County (520) 615-6200
TLC PAIN & PALLIATIVE MEDICINE PRACTICE, INC
Pain Medicine (Pain Medicine)
1775 E SKYLINE DR, STE 101
TUCSON, AZ 85718
Pima County (520) 615-6200
MYUNGHAN CHOI PHD, MPH, APRN, BC
Nurse Practitioner (Adult Health)
1775 E SKYLINE DR, STE 101
TUCSON, AZ 85718
Pima County (520) 615-6200
ELAINE J CHARTERIS ANP
Nurse Practitioner (Adult Health)
1775 E SKYLINE DR, #101
TUCSON, AZ 85718
Pima County (520) 615-6200
JENNIFER A RAMIN ANP
Nurse Practitioner (Adult Health)
1775 E SKYLINE DR, STE 101
TUCSON, AZ 85718
Pima County (520) 615-6200
CAROL J BLANKENSHIP LCSQ
Social Worker (Clinical)
1775 E SKYLINE DR, STE 101
TUCSON, AZ 85718
Pima County (520) 615-6200
ANNA DESIMONE FNP
Nurse Practitioner (Family)
1775 E SKYLINE DR, STE 101
TUCSON, AZ 85718
Pima County (520) 615-6200

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 Edwin Gilliam's NPI number?

The NPI number for Edwin Gilliam is 1952383143. It was assigned to this individual provider in the NPPES registry on November 15, 2005.

Where is Edwin Gilliam located?

Edwin Gilliam practices at 1775 E Skyline Dr Ste 101, Tucson, AZ 85718. The listed phone number is (520) 615-6200.

What is Edwin Gilliam's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Edwin Gilliam enrolled in Medicare?

Yes. Edwin Gilliam 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.

Which organizations bill Medicare for Edwin Gilliam's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Edwin Gilliam reassigns Medicare benefits to 3 organizations: Sound Physicians Intensivists Of Arizona, Inc (Tucson, AZ), Tucson Physician Group Holdings, LLC (Tucson, AZ) and Cogent Healthcare Of Arizona PC (Sierra Vista, AZ). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Edwin Gilliam's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Edwin Gilliam accept?

Health plans from Ambetter from Arizona Complete Health, Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona and Imperial Insurance Companies, Inc. list Edwin Gilliam as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Edwin Gilliam was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.