Individual provider Active NPI

Eduardo P Yabut, M.D.

  • Psychiatry Physician
  • Jamestown, ND
National Provider Identifier
1457395691
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
9005 Issued in ND
Practice address
520 3Rd St NW
Jamestown, ND 58401-2968
Phone
(701) 253-6300
Fax
(701) 253-6400
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 9005 ND Primary

Addresses

Primary practice location

520 3Rd St NW
Jamestown, ND 58401-2968

Mailing address

520 3Rd St NW
PO Box 2055
Jamestown, ND 58402-2055
Phone (701) 253-6300

Other identifiers 2

IdentifierTypeStateIssuer
260049812OtherNDRR MEDICARE
021871OtherNDBCBS PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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

Enrollment IDStateProvider typePAC IDDetails
I20100901000145 ND Practitioner - Psychiatry 6406970235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Dakota State HospitalGroup PAC ID 5698734374, 9 clinicians

Practice addresses (Care Compare)

2605 Circle Dr
Jamestown, ND 58401-6905
Phone (701) 253-3650

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9005NDMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Appalachian Regional Healthcare, Inc Past Accepting new patients
South Central Human Service Center PastSince Sep 23, 2024 Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
North Dakota State HospitalJamestown, ND, CCN 354003 Hospital Operational/Managerial Control (100%) Mar 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1457395691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 3RD ST NW",
            "address_2": "PO BOX 2055",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584022055",
            "telephone_number": "701-253-6300",
            "fax_number": "701-253-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 3RD ST NW",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584012968",
            "telephone_number": "701-253-6300",
            "fax_number": "701-253-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YABUT",
        "first_name": "EDUARDO",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ND",
            "license": "9005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "260049812",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "021871",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, ND

Sources for this page

Verify at the official NPI Registry.