NPIMap

Organization Active NPI

Mobilemed, PLLC

  • Internal Medicine Physician
  • El Paso, TX
National Provider Identifier
1013553874
Registry record updated Sep 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MOBILEMED, PLLC
Practice address
1201 E Schuster Ave Ste 1a
El Paso, TX 79902-4646
Phone
(915) 307-4669
NPI assigned
Nov 26, 2019
Last updated
Sep 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2024

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

Authorized official

Name
Jose Burgos, MDNPI 1245437425
Title
Owner
Phone
(915) 307-4669

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU
Internal Medicine Physician 207R00000X NU Primary
Psychiatry Physician 2084P0800X NU
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X NU

Addresses

Primary practice location

1201 E Schuster Ave Ste 1a
El Paso, TX 79902-4646

Mailing address

4849 N Mesa St Ste 201
El Paso, TX 79912-5919
Phone (915) 351-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200108001425 TX Part B Supplier - Clinic/Group Practice 0446685051 Receives reassigned benefits from 19 practitioners
Practice locations: El Paso, TX; Houston, TX
O20240821004903 NM Part B Supplier - Clinic/Group Practice 0446685051 Receives reassigned benefits from 7 practitioners
Practice locations: Las Cruces, NM

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2311377Mobilemed PLLC1201 E. Schuster Avenue, Suite 1a, El Paso, TX 79902Certificate of waiverSep 19, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1574726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726358400000",
    "number": "1013553874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4849 N MESA ST STE 201",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799125919",
            "telephone_number": "915-351-6600",
            "fax_number": "915-351-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 E SCHUSTER AVE STE 1A",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799024646",
            "telephone_number": "915-307-4669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILEMED, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-26",
        "last_updated": "2024-09-15",
        "certification_date": "2024-09-15",
        "status": "A",
        "authorized_official_last_name": "BURGOS",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "915-307-4669",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 15, 2024; 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.