Individual provider Active NPI

Yasuhiro Nakatani, MD

  • Infectious Disease Physician
  • Albuquerque, NM
National Provider Identifier
1114901329
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
95-309 Issued in NM
Practice address
1 University of New Mexico
MSC 10-5550
Albuquerque, NM 87131-0001
Phone
(505) 272-5666
Fax
(505) 272-4435
NPI assigned
Dec 1, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 36376 MN
Infectious Disease Physician 207RI0200X 95-309 NM Primary
Infectious Disease Physician 207RI0200X A054401 CA
Infectious Disease Physician 207RI0200X 22376 AZ
Infectious Disease Physician 207RI0200X 01057741A IN
Infectious Disease Physician 207RI0200X 38165 KY

Addresses

Primary practice location

1 University of New Mexico
MSC 10-5550
Albuquerque, NM 87131-0001

Mailing address

933 Bradbury Drive SE
Suite 2222
Albuquerque, NM 87106-4374
Phone (505) 272-3120

Other identifiers 1

IdentifierTypeStateIssuer
180753MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170925002650 NM Practitioner - Internal MedicinePractitioner - Infectious Disease 3274447149 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A054401CAMDInfectious Disease Physician
01057741AINMDInfectious Disease Physician
38165KYMDInfectious Disease Physician
36376MNMDPediatrics Physician
TP774KYMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Unm Medical Group Inc CurrentSince Aug 18, 2017 Accepting new patients
Unm Medical Group, Inc. CurrentSince Aug 18, 2017 Accepting new patients
Banner-University Medical Group Past Accepting new patients
Banner Pharmacy Services LLC Past Accepting new patients
University of Louisville Research Foundation Past Accepting new patients
University Medical Associates Past Accepting new patients
University Physicians Group - Radiology Past Accepting new patients

Locations

933 Bradbury Dr SE
Ste 2222
Albuquerque, NM 87106
Phone (505) 272-1476

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1114901329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 BRADBURY DRIVE SE",
            "address_2": "SUITE 2222",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064374",
            "telephone_number": "505-272-3120",
            "fax_number": "505-272-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY OF NEW MEXICO",
            "address_2": "MSC 10-5550",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-272-5666",
            "fax_number": "505-272-4435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKATANI",
        "first_name": "YASUHIRO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MN",
            "license": "36376",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NM",
            "license": "95-309",
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "A054401",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "AZ",
            "license": "22376",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "IN",
            "license": "01057741A",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "KY",
            "license": "38165",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180753",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.