Ethan Benjamin Deckert, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

7977 Issued in NE

Practice address

700 Camino de Salud
Albuquerque, NM 87106-3740

Phone

(505) 272-5062

NPI assigned

Jun 23, 2017

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

Medicare fee-for-service enrollment

Enrolled in NM, WA2 enrollments

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 2

Merit-based Incentive Payment System (MIPS)

Final score

96.29 of 100Reported as group

Quality

90.36

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Unm Medical Group Inc

  • Multi-Specialty Clinic/Center
  • Albuquerque, NM
  • NPI 1831218627
  Medicare reassignment NPD
• Providence Health & Services - Washington

  • Critical Access Hospital
  • Colville, WA
  • NPI 1003067679
  Medicare reassignment NPD
• Providence Health & Services - Washington

  • Critical Access Hospital
  • Colville, WA
  • NPI 1841442332
  Medicare reassignment NPD
• Unm Medical Group, Inc.

  • Community/Retail Pharmacy
  • Albuquerque, NM
  • NPI 1417330044
  NPD
• Unmc

  • General Acute Care Hospital
  • Omaha, NE
  • NPI 1962625772
  NPD (past)

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

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1326568080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981150 NEBRASKA MEDICAL CTR",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681981150",
            "telephone_number": "402-559-6802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CAMINO DE SALUD",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871063740",
            "telephone_number": "505-272-5062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "981150 Nebraska Medical Ctr",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681981150",
            "country_code": "US",
            "telephone_number": "402-559-6802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DECKERT",
        "first_name": "ETHAN",
        "middle_name": "BENJAMIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-23",
        "last_updated": "2022-07-21",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NM",
            "license": "7977",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NE",
            "license": "7977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Maxwell Decker, AUD
• Juniper Decker, LPCC
• Lauren Decker, MD
• Linda Clarice Decker, LMT
• Sharlene Decker, LADAC
• Decorazon Modifications LLC
• Danessa Rene Decosta
• Thomas Decoster, MD
• Jean-Paul Henri Dedam, MD
• Dereck Dedeaux

• Emergency Medicine Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Emergency Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.