Jed J Tatsuyama, MD, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

JED J TATSUYAMA, MD, PC

Practice address

1619 N Greenwood St
Suite 200
Pueblo, CO 81003-2644

Phone

(719) 543-1130

NPI assigned

Feb 27, 2008

Last updated

Jun 22, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jed J Tatsuyama, MDNPI 1114960192

Title

President

Phone

(719) 543-1130

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jed Jitsugo Tatsuyama, MD

  • Family Medicine Physician
  • Pueblo, CO
  • NPI 1114960192
  Authorized official Same address or phone
• John P Lieberman, M.D.

  • Specialist
  • Pueblo, CO
  • NPI 1427086107
  NPD (past)
• Diane Noriko Tatsuyama, CCC-SLP

  • Speech-Language Pathologist
  • Pueblo, CO
  • NPI 1861700650
  NPD (past)

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214092800000",
    "number": "1992974554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 N GREENWOOD ST",
            "address_2": "SUITE 200",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032644",
            "telephone_number": "719-543-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 N GREENWOOD ST",
            "address_2": "SUITE 200",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032644",
            "telephone_number": "719-543-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JED J TATSUYAMA, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2008-06-22",
        "status": "A",
        "authorized_official_last_name": "TATSUYAMA",
        "authorized_official_first_name": "JED",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-543-1130",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "59825731",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olga Jasina
• Bryant Pinto Javier, DO
• Rose Marie Javornik
• JB Pharmacy Inc
• Jeanne Graves (Dental Hygiene Services)
• Adam Jeffryes, MA, LPC
• Abigail Jenkins, BCABA
• Adam Jennings, PT
• Brian Jensen
• Jonathan Joseph Jensen, MT

• Family Medicine Physician in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2008; 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.