Individual provider Active NPI

Ricardo Brownlee Eusebio, MD

  • Surgery Physician
  • Tamuning, GU
National Provider Identifier
1679795603
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
M-1017 Issued in GU
Practice address
633 Gov Carlos Camacho Road
Ste 202
Tamuning, GU 86913-3143
Phone
(671) 646-0443
Fax
(671) 646-0440
NPI assigned
May 2, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X M-1017 GU Primary
Pediatric Surgery Physician 2086S0120X M-1017 GU
Vascular Surgery Physician 2086S0129X M-1017 GU

Addresses

Primary practice location

633 Gov Carlos Camacho Road
Ste 202
Tamuning, GU 86913-3143

Mailing address

633 Gov Carlos Camacho Road
Ste 202
Tamuning, GU 86913-3143
Phone (671) 646-0443

Other identifiers 3

IdentifierTypeStateIssuer
M001017OtherGUMEDICAL LICENSE GUAM BOAR
217MedicaidGU
10M1017AOtherGUCONTROLLED SUBSTANCE DEPT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU, MP2 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

Enrollment IDStateProvider typePAC IDDetails
I20040622000639 GU Practitioner - General SurgeryPractitioner - Vascular Surgery 7911896774 Reassigns benefits to 2 organizations
I20220615003239 MP Practitioner - General Surgery 7911896774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular Surgery
Education
George Washington University School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Island Surgical Center PCGroup PAC ID 3870860513, 2 clinicians

Practice addresses (Care Compare)

133 Route 3
Dededo, GU 96929-6911
Phone (671) 645-5500

171 Farenholt Ave
Tamuning, GU 96913-3207
Phone (671) 646-0441

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.22 of 100Reported as group
Quality
78.84
Improvement activities
40
Cost
61.61

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Healthcare Corporation Current Accepting new patients
Guam Healthcare Development Incorporated CurrentSince May 3, 2019 Accepting new patients
Commonwealth Healthcare Corporation CurrentSince May 2, 2022 Accepting new patients
Commonwealth Healthcare Corporation CurrentSince May 2, 2022 Accepting new patients
Island Surgical Center, P.C. Surgery CurrentSince Apr 8, 2017 Accepting new patients

Locations

133 Route 3
Dededo, GU 96929
Phone (671) 645-5500

171 Farenholt Ave
Tamuning, GU 96913
Phone (671) 646-0441

850 Gov Carlos G Camacho Rd
Tamuning, GU 96913
Phone (671) 647-2555

850 Gov Carlos G Camacho Rd
#R
Tamuning, GU 96913
Phone (671) 647-2552

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1679795603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 GOV CARLOS CAMACHO ROAD",
            "address_2": "STE 202",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "869133143",
            "telephone_number": "671-646-0443",
            "fax_number": "671-646-0440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 GOV CARLOS CAMACHO ROAD",
            "address_2": "STE 202",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "869133143",
            "telephone_number": "671-646-0443",
            "fax_number": "671-646-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUSEBIO",
        "first_name": "RICARDO",
        "middle_name": "BROWNLEE",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GU",
            "license": "M-1017",
            "primary": true
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "GU",
            "license": "M-1017",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "GU",
            "license": "M-1017",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE GUAM BOAR",
            "identifier": "M001017",
            "state": "GU"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "217",
            "state": "GU"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE DEPT",
            "identifier": "10M1017A",
            "state": "GU"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamuning, GU

Sources for this page

Verify at the official NPI Registry.