Individual provider Active NPI

Jonnalyn R. Belocura, M.D.

  • Family Medicine Physician
  • El Paso, TX
National Provider Identifier
1033116793
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L1268 Issued in TX
Practice address
11345 Montwood Dr
Suite a-1
El Paso, TX 79936-3844
Phone
(915) 921-5200
Fax
(915) 921-5299
NPI assigned
Jul 7, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L1268 TX Primary

Addresses

Primary practice location

11345 Montwood Dr
Suite a-1
El Paso, TX 79936-3844

Mailing address

11345 Montwood Dr
Suite a-1
El Paso, TX 79936-3844
Phone (915) 921-5200

Other identifiers 2

IdentifierTypeStateIssuer
0022HBOtherTXBLUE CROSS BLUE SHIELD
000Z0453MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jul 1, 2024 through Jul 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L1268TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group Family Medicine Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033116793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11345 MONTWOOD DR",
            "address_2": "SUITE A-1",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799363844",
            "telephone_number": "915-921-5200",
            "fax_number": "915-921-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11345 MONTWOOD DR",
            "address_2": "SUITE A-1",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799363844",
            "telephone_number": "915-921-5200",
            "fax_number": "915-921-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELOCURA",
        "first_name": "JONNALYN",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L1268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0022HB",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000Z0453",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.