Individual provider Active NPI

Cristina Celino Nemenzo, P.T.

  • Physical Therapist
  • El Paso, TX
National Provider Identifier
1013044122
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1203130 Issued in TX
Practice address
612 N Resler Dr
El Paso, TX 79912-2369
Phone
(915) 584-5683
Fax
(915) 584-5657
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2374 NM
Physical Therapist 225100000X 1203130 TX Primary

Addresses

Primary practice location

612 N Resler Dr
El Paso, TX 79912-2369

Mailing address

612 N Resler Dr
El Paso, TX 79912-2369
Phone (915) 584-5683

Other identifiers 1

IdentifierTypeStateIssuer
55508065MedicaidNM

Other names 1

  • Cristina Cerdan Celino Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150515000610 TX Practitioner - Physical Therapist in Private Practice 1557681525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paloma Wellness and Rehabilitation PLLCGroup PAC ID 8729229406, 3 clinicians

Practice addresses (Care Compare)

1188 N Yarbrough Dr
Suite S
El Paso, TX 79925-7926
Phone (915) 600-5020

6559 N Mesa St
El Paso, TX 79912-4417
Phone (915) 584-5683

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2374NMMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Paloma Wellness and Rehabilitation PLLC Physical Therapist CurrentSince Mar 1, 2015 Accepting new patients

Locations

612 N Resler Dr
El Paso, TX 79912
Phone (915) 584-5683

1188 N Yarbrough Dr
Ste S
El Paso, TX 79925
Phone (915) 504-1715

6559 N Mesa St
El Paso, TX 79912
Phone (915) 584-5683

Organizations & group practices 1

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430265600000",
    "number": "1013044122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 N RESLER DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799122369",
            "telephone_number": "915-584-5683",
            "fax_number": "915-584-5657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 N RESLER DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799122369",
            "telephone_number": "915-584-5683",
            "fax_number": "915-584-5657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMENZO",
        "first_name": "CRISTINA",
        "middle_name": "CELINO",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2015-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "2374",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1203130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55508065",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRISTINA",
            "last_name": "CELINO",
            "middle_name": "CERDAN",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.