Individual provider Active NPI

Eugene Fayerberg, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Albuquerque, NM
National Provider Identifier
1568738912
Registry record updated Feb 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
MD2014-0928 Issued in NM
Practice address
1100 Central Ave SE
PMG Emergency Medicine
Albuquerque, NM 87106-4930
Phone
(505) 841-1125
Fax
(505) 841-1737
NPI assigned
Mar 30, 2012
Last updated
Feb 19, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X MD2014-0928 NM Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1100 Central Ave SE
PMG Emergency Medicine
Albuquerque, NM 87106-4930

Mailing address

PO Box 26666
Presbyterian Healthcare Services
Albuquerque, NM 87125

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD2014-0928NMMDEmergency Medical Services (Emergency Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1333065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424304000000",
    "number": "1568738912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PRESBYTERIAN HEALTHCARE SERVICES",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CENTRAL AVE SE",
            "address_2": "PMG EMERGENCY MEDICINE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064930",
            "telephone_number": "505-841-1125",
            "fax_number": "505-841-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAYERBERG",
        "first_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-30",
        "last_updated": "2015-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NM",
            "license": "MD2014-0928",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Feb 19, 2015; 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.