Individual provider Active NPI

Yosuke Ebisu, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Albuquerque, NM
National Provider Identifier
1518308428
Registry record updated Jul 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
RS2013-0468 Issued in NM
Practice address
1 University of New Mexico
Mail Stop Code 10-5550
Albuquerque, NM 87131
Phone
(505) 272-5666
NPI assigned
Jul 9, 2013
Last updated
Jul 16, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X RS2013-0468 NM Primary

Addresses

Primary practice location

1 University of New Mexico
Mail Stop Code 10-5550
Albuquerque, NM 87131

Mailing address

1 University of New Mexico
Mail Stop Code 10-5550
Albuquerque, NM 87131
Phone (505) 272-5666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
RS2013-0468NMMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373932800000",
    "number": "1518308428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY OF NEW MEXICO",
            "address_2": "MAIL STOP CODE 10-5550",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87131",
            "telephone_number": "505-272-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY OF NEW MEXICO",
            "address_2": "MAIL STOP CODE 10-5550",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87131",
            "telephone_number": "505-272-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBISU",
        "first_name": "YOSUKE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-09",
        "last_updated": "2013-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": "RS2013-0468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2013; 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.