Active NPI
Clsudio Rebosura Decena
- Surgery Physician
- Lansing, KS
National Provider Identifier
1245257914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 0418828
- Practice address
- 117 Rock Creek Loop
Lansing, KS 66043-6211 - Phone
- (913) 250-0468
- NPI assigned
- Jul 17, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 0418828 | KS | Primary |
Addresses
Primary practice location
117 Rock Creek Loop
Lansing, KS 66043-6211
Mailing address
4101 S 4TH St
Leavenworth, KS 66048-5014
Phone (913) 682-2000
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0418828 | KS | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245257914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4101 S 4TH ST",
"city": "LEAVENWORTH",
"state": "KS",
"postal_code": "660485014",
"telephone_number": "913-682-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 ROCK CREEK LOOP",
"city": "LANSING",
"state": "KS",
"postal_code": "660436211",
"telephone_number": "913-250-0468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DECENA",
"first_name": "CLSUDIO",
"middle_name": "REBOSURA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "KS",
"license": "0418828",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lansing, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.