Individual provider Active NPI

Eun Bellisario, CNP

  • Family Nurse Practitioner
  • Cuba, NM
National Provider Identifier
1962015958
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
61906 Issued in NM
Practice address
6349 US Highway 550
Cuba, NM 87013-6032
Phone
(575) 289-3291
Fax
(505) 443-8303
NPI assigned
Aug 28, 2020
Last updated
Jul 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11008838 FL
Family Nurse Practitioner 363LF0000X 61906 NM Primary

Addresses

Primary practice location

6349 US Highway 550
Cuba, NM 87013-6032

Mailing address

6349 US Highway 550
Cuba, NM 87013-6032
Phone (575) 289-3291

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210706000616 NM Practitioner - Nurse Practitioner 3577965185 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Medical ServicesGroup PAC ID 2062324684, 132 clinicians

Practice addresses (Care Compare)

1422 Paseo de Peralta
Santa Fe, NM 87501-4391
Phone (505) 982-5565

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11008838FLMDNurse Practitioner
61906NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Medical Services CurrentSince Dec 26, 2023 Accepting new patients
Presbyterian Medical Services CurrentSince Dec 26, 2023 Accepting new patients
Omni Medical Group LLC CurrentSince Mar 18, 2021 Accepting new patients
Nextcare New Mexico LLC CurrentSince Jun 29, 2022 Accepting new patients
Presbyterian Medical Services Current Accepting new patients

Locations

4201 Central Ave NW
Ste K3
Albuquerque, NM 87105
Phone (505) 369-1239

8201 Golf Course Rd NW
Albuquerque, NM 87120
Phone (505) 800-7070

1217 Bonita St
Grants, NM 87020
Phone (505) 287-2950

1422 Paseo de Peralta
Santa Fe, NM 87501
Phone (505) 982-5565

Interoperability endpoints

  • Direct secure messaging: eun.bellisario.p1@direct.pmsnm.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1962015958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6349 US HIGHWAY 550",
            "city": "CUBA",
            "state": "NM",
            "postal_code": "870136032",
            "telephone_number": "575-289-3291",
            "fax_number": "505-443-8303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6349 US HIGHWAY 550",
            "city": "CUBA",
            "state": "NM",
            "postal_code": "870136032",
            "telephone_number": "575-289-3291",
            "fax_number": "505-443-8303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLISARIO",
        "first_name": "EUN",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-28",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11008838",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "61906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cuba, NM

Sources for this page

Verify at the official NPI Registry.