Cersosimo Primary Care, P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CERSOSIMO PRIMARY CARE, P.C.

Practice address

3900 Eubank Blvd NE Ste 3C
Albuquerque, NM 87111-3427

Phone

(505) 336-6113

Fax

(505) 544-5136

NPI assigned

Feb 13, 2021

Last updated

Feb 13, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Shaylin Cersosimo, MD

Title

Family Physician

Phone

(505) 336-6113

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1613174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613174400000",
    "number": "1316530033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 EUBANK BLVD NE STE 3C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113427",
            "telephone_number": "505-336-6113",
            "fax_number": "505-544-5136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 EUBANK BLVD NE STE 3C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113427",
            "telephone_number": "505-336-6113",
            "fax_number": "505-544-5136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CERSOSIMO PRIMARY CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-13",
        "last_updated": "2021-02-13",
        "certification_date": "2021-02-13",
        "status": "A",
        "authorized_official_last_name": "CERSOSIMO",
        "authorized_official_first_name": "SHAYLIN",
        "authorized_official_title_or_position": "FAMILY PHYSICIAN",
        "authorized_official_telephone_number": "505-336-6113",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Albuquerque, NM
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.