Emmanuel J. Eusebio, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD00030270 Issued in WA

Practice address

Peacehealth Medical Group
4545 Cordata Parkway, Suite 1F
Bellingham, WA 98226

Phone

(360) 738-2200

Fax

(360) 752-5679

NPI assigned

Oct 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: meusebio399510@direct.peacehealth.org

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.

• Peacehealth

  • Internal Medicine Physician
  • Bellingham, WA
  • NPI 1356309553

  Pediatrics

  Medicare reassignment NPD
• Peacehealth

  • Critical Access Hospital
  • Friday Harbor, WA
  • NPI 1487917233
  Medicare reassignment NPD
• Peacehealth

  • Emergency Medicine Physician
  • Friday Harbor, WA
  • NPI 1508129842
  Medicare reassignment NPD
• Peacehealth

  • Sleep Disorder Diagnostic Clinic/Center
  • Bellingham, WA
  • NPI 1265692842
  NPD (past)
• Peacehealth

  • Multi-Specialty Clinic/Center
  • Bellingham, WA
  • NPI 1457553497
  NPD (past)

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1316936164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 SE 164TH AVE DEPT 358",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986838004",
            "telephone_number": "360-729-1462",
            "fax_number": "360-729-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PEACEHEALTH MEDICAL GROUP",
            "address_2": "4545 CORDATA PARKWAY, SUITE 1F",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "98226",
            "telephone_number": "360-738-2200",
            "fax_number": "360-752-5679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10416 5th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "98125",
            "country_code": "US",
            "telephone_number": "206-517-6700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EUSEBIO",
        "first_name": "EMMANUEL",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "MD00030270",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00030270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083229",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Thomas Etue, DC
• Craig Allen Eubank, CRAIG EUBANK
• Kelly Eubank
• John C Eudy III, PA
• Claire Evans, MSW, LICSW, BCD
• Ethan Spencer Evans
• Kelly L Evans, M.D.
• Richard J Evans V, MA
• Evergreen AIDS Foundation

• Pediatrics Physician in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.