Individual provider Active NPI

Homero Guaderrama, FNP-C

  • Primary Care Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1013466390
Registry record updated Sep 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AP132054 Issued in TX
Practice address
300 S Zaragoza Rd
El Paso, TX 79907-6635
Phone
(915) 790-5700
NPI assigned
Sep 27, 2016
Last updated
Sep 27, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X AP132054 TX Primary

Addresses

Primary practice location

300 S Zaragoza Rd
El Paso, TX 79907-6635

Mailing address

300 S Zaragoza Rd
El Paso, TX 79907-6635
Phone (915) 790-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20161227000613 TX Practitioner - Nurse Practitioner 6608157037 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El Paso County Hospital DistrictGroup PAC ID 2365431509, 208 clinicians

Practice addresses (Care Compare)

1521 Joe Battle Blvd
El Paso, TX 79936-6286
Phone (915) 760-5700

4815 Alameda Ave
El Paso, TX 79905-2705
Phone (915) 521-7902

4845 Alameda Ave
El Paso, TX 79905-2705
Phone (915) 298-5444

5500 N Desert Blvd
Suite a 1
El Paso, TX 79912-1641
Phone (915) 790-5700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP132054TXMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
El Paso County Hospital District CurrentSince Oct 24, 2016 Accepting new patients
Umc El Paso Healthcare Inc CurrentSince Jul 1, 2025 Accepting new patients
El Paso County Hospital District CurrentSince Oct 24, 2016 Accepting new patients

Locations

300 S Zaragoza Rd
El Paso, TX 79907
Phone (915) 790-5707

4500 N Mesa St
El Paso, TX 79912
Phone (915) 532-9000

4815 Alameda Ave
El Paso, TX 79905
Phone (915) 215-6000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24611/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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 3

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": "1474934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474934400000",
    "number": "1013466390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S ZARAGOZA RD",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799076635",
            "telephone_number": "915-790-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S ZARAGOZA RD",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799076635",
            "telephone_number": "915-790-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUADERRAMA",
        "first_name": "HOMERO",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-27",
        "last_updated": "2016-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP132054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.