Individual provider Active NPI

Xingyou Shi

  • Dentist
  • Albuquerque, NM
National Provider Identifier
1821611054
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DD5320 Issued in NM
Practice address
1217 1St St NW
Albuquerque, NM 87102-1529
Phone
(505) 766-5197
NPI assigned
May 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DD5320 NM Primary

Addresses

Primary practice location

1217 1St St NW
Albuquerque, NM 87102-1529

Mailing address

PO Box 25445
Albuquerque, NM 87125-0445
Phone (505) 766-5197

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210930000789 NM Practitioner - Dentist 8628475852 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DD5320NMMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Albuquerque Health Care for the Homeless, Inc. CurrentSince Sep 20, 2021 Accepting new patients
Family Smiles, LLC PastSince May 1, 2020 Accepting new patients

Locations

1217 1st St NW
Albuquerque, NM 87102
Phone (505) 242-4644

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IJDGBD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1590019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1821611054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25445",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871250445",
            "telephone_number": "505-766-5197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 1ST ST NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021529",
            "telephone_number": "505-766-5197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHI",
        "first_name": "XINGYOU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-21",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD5320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.