Individual provider Active NPI

Eugene Hipolito

  • Registered Nurse
  • Vallejo, CA
National Provider Identifier
1073192852
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95208901 Issued in CA
Practice address
515 Goheen Cir
Vallejo, CA 94591-4116
Phone
(707) 567-5456
NPI assigned
Apr 7, 2021
Last updated
Apr 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95208901 CA Primary

Addresses

Primary practice location

515 Goheen Cir
Vallejo, CA 94591-4116

Mailing address

515 Goheen Cir
Vallejo, CA 94591-4116
Phone (707) 567-5456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
95208901CAMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1073192852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 GOHEEN CIR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945914116",
            "telephone_number": "707-567-5456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 GOHEEN CIR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945914116",
            "telephone_number": "707-567-5456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIPOLITO",
        "first_name": "EUGENE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95208901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.