NPIMap

Individual provider Active NPI

Bryan Botello, NP

  • Acute Care Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1003495912
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1034153 Issued in TX
Practice address
4305 N Mesa St
El Paso, TX 79902-1123
Phone
(915) 532-2477
Fax
(915) 242-6461
NPI assigned
Apr 7, 2021
Last updated
Apr 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1034153 TX Primary

Addresses

Primary practice location

4305 N Mesa St
El Paso, TX 79902-1123

Mailing address

4305 N Mesa St Ste a
El Paso, TX 79902-1124
Phone (915) 532-2477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210429002315 TX Practitioner - Nurse Practitioner 9739598996 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
Sunset Heights Physician Services PAGroup PAC ID 9830683705, 61 clinicians
Hospitalist Medicine Physicians of Texas PLLCGroup PAC ID 3476688318, 685 clinicians

Practice addresses (Care Compare)

1625 Medical Ctr Dr
El Paso, TX 79902-5005
Phone (915) 747-4000

2001 N Oregon St
Providence Memorial Hospital
El Paso, TX 79902-3320
Phone (915) 577-6011

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sunset Heights Physician Services PA CurrentSince Jan 26, 2026 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC CurrentSince Oct 1, 2021 Accepting new patients
Cogent Healthcare of Texas, PA CurrentSince Sep 1, 2021 Accepting new patients
El Paso Pulmonary Association Past Accepting new patients

Locations

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

1625 Medical Center Dr
El Paso, TX 79902
Phone (915) 577-7746

2001 N Oregon St
El Paso, TX 79902
Phone (915) 577-6011

3280 Joe Battle Blvd
El Paso, TX 79938
Phone (915) 577-6000

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Organizations & group practices 4

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 7

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": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1003495912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 N MESA ST STE A",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799021124",
            "telephone_number": "915-532-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 N MESA ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799021123",
            "telephone_number": "915-532-2477",
            "fax_number": "915-242-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTELLO",
        "first_name": "BRYAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-04-07",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1034153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.