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EDISON VIRGIL ETSITTY M.D. NPI 1376521500


NPI Information

NPI: 1376521500
Provider Name: EDISON VIRGIL ETSITTY, M.D.
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
465 SAINT MICHAELS DR
SUITE 202
SANTA FE, NM
ZIP 87505
Phone: (505) 984-0303
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Edison Virgil Etsitty, M.D. is an obstetrics gynecology in Santa Fe, NM with 26 years of experience. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. Edison Virgil Etsitty, M.D. NPI is 1376521500. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF NEW MEXICO SCHOOL OF MEDICINE
Graduation Year:1998

The provider's business location address is:

465 SAINT MICHAELS DR
SUITE 202
SANTA FE, NM
ZIP 87505-670
Phone: (505) 984-0303
Fax: (505) 984-1116

The NPI 1376521500 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/6/2006 and was last updated on 2/10/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207V00000XObstetrics & Gynecology2002-0299NEW MEXICOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1H70931MEDICARE UPIN
250733826MEDICAIDNEW MEXICO
3PROVP12721OTHERMOLINA
4723040MEDICAIDARIZONA
5160058344OTHERRAILROAD MEDICARE
610003903OTHERNEW MEXICOLOVELACE HEALTH/SALUD
7201038402OTHERNEW MEXICOPRESBYTERIAN HEALTH/SALUD
8NM009C04OTHERNEW MEXICOBC/BS
9850313268020OTHERCHAMPUS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.