NPIMap

Individual provider Active NPI

Daniel Shibuya, MD

  • Neurology Physician
  • Albuquerque, NM
National Provider Identifier
1275639304
Registry record updated Apr 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
95-345 Issued in NM
Practice address
500 Walter St NE
Ste 401
Albuquerque, NM 87102-2563
Phone
(505) 727-5910
Fax
(505) 727-5939
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 95-345 NM
Neurology Physician 2084N0400X 95-345 NM Primary

Addresses

Primary practice location

500 Walter St NE
Ste 401
Albuquerque, NM 87102-2563

Mailing address

500 Walter St NE
Ste 401
Albuquerque, NM 87102-2563
Phone (505) 727-5910

Other identifiers 1

IdentifierTypeStateIssuer
000E9308MedicaidNM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050119000231 NM Practitioner - Neurology 7012966856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of California, San Diego School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southwest Medical Associates, LLCGroup PAC ID 7214831114, 326 clinicians

Practice addresses (Care Compare)

500 Walter St NE
Suite 501
Albuquerque, NM 87102-2521
Phone (505) 727-3170

715 Dr Martin Luther King Jr Ave NE
Suite 301
Albuquerque, NM 87102-3668
Phone (505) 727-7090

Hospital & facility affiliations

  • Presbyterian Hospital Hospital, Albuquerque, NM, CCN 320021
  • Lovelace Westside Hospital Hospital, Albuquerque, NM, CCN 320074
  • Lovelace Women'S Hospital Hospital, Albuquerque, NM, CCN 320017
  • Lovelace Medical Center Hospital, Albuquerque, NM, CCN 320009
  • Christus St Vincent Regional Medical Center Hospital, Santa Fe, NM, CCN 320002
  • Lovelace Unm Rehabilitation Hospital Inpatient rehabilitation facility, Albuquerque, NM, CCN 323028

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Associates, LLC CurrentSince Jun 1, 1998 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Jun 1, 1998 Accepting new patients

Locations

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

6701 Jefferson St NE
Albuquerque, NM 87109
Phone (505) 727-0600

500 Walter St NE
Ste 401
Albuquerque, NM 87102
Phone (505) 727-5910

6100 Pan American East Fwy NE
Ste 100
Albuquerque, NM 87109
Phone (505) 727-6200

Interoperability endpoints

  • Direct secure messaging: dshibuya11055@ahs.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492560000000",
    "number": "1275639304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WALTER ST NE",
            "address_2": "STE 401",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022563",
            "telephone_number": "505-727-5910",
            "fax_number": "505-727-5939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WALTER ST NE",
            "address_2": "STE 401",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022563",
            "telephone_number": "505-727-5910",
            "fax_number": "505-727-5939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIBUYA",
        "first_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2017-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NM",
            "license": "95-345",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NM",
            "license": "95-345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E9308",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.