Active NPI
Eiri Kisamori, MD
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- 78241
- Practice address
- 1919 E Thomas Rd
Phoenix, AZ 85016-7710 - Phone
- (602) 933-2693
- NPI assigned
- Jul 14, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 78241 | AZ | Primary |
Addresses
Primary practice location
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Mailing address
2108 E Thomas Rd Ste 130
Phoenix, AZ 85016-0008
Phone (602) 933-3124
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | ekisamori@childrensnational.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Thoracic Surgery
- Education
- Other, 2015
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2108 E Thomas Rd
Suite 130
Phoenix, AZ 85016-0008
2108 E Thomas Rd
Suite 130
Phoenix, AZ 85016-7761
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 328887 | NY | MD | Licensed Practical Nurse |
| 78241 | AZ | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phoenix Children'S Medical Group | Current | Accepting new patients | |
| Phoenix Children'S Hospital | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients |
Locations
1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777
2108 E Thomas Rd
Ste 130
Phoenix, AZ 85016
3959 Broadway
New York, NY 10032
Phone (212) 304-7297
177 Fort Washington Ave
Ste 7435
New York, NY 10032
Phone (212) 305-8312
161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559
622 W 168th St
New York, NY 10032
Phone (212) 305-4931
622 W 168th St
Ph 3303
New York, NY 10032
Phone (212) 305-2654
Interoperability endpoints
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
- ebh9008@direct.nyp.org
Organizations & group practices 4
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.
-
- Pediatrics Physician
- Phoenix, AZ
- NPI 1922112044
-
- Surgery Physician
- New York, NY
- NPI 1508266347
-
- Multi-Specialty Clinic/Center
- Mesa, AZ
- NPI 1487814240
-
- Internal Medicine Physician
- New York, NY
- NPI 1699289488
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759881600000",
"number": "1518691658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2108 E THOMAS RD STE 130",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850160008",
"telephone_number": "602-933-3124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 E THOMAS RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850167710",
"telephone_number": "602-933-2693"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISAMORI",
"first_name": "EIRI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-14",
"last_updated": "2025-10-08",
"certification_date": "2025-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "AZ",
"license": "78241",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "ekisamori@childrensnational.org",
"affiliation": "N",
"endpointDescription": "E-mail",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "111 Michigan Ave NW Ste 400500",
"city": "Washington",
"state": "DC",
"country_code": "US",
"postal_code": "200102916",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; 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.