Individual provider Active NPI

Jorge Ivan Contreras, M.D.

  • Otolaryngology Physician
  • El Paso, TX
National Provider Identifier
1033315411
Registry record updated Aug 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
P7624 Issued in TX
Practice address
5959 Gateway Blvd W
160
El Paso, TX 79925-3331
Phone
(915) 779-1716
NPI assigned
Jun 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X RS20070279 NM
Otolaryngology Physician 207Y00000X P7624 TX Primary

Addresses

Primary practice location

5959 Gateway Blvd W
160
El Paso, TX 79925-3331

Mailing address

5959 Gateway Blvd W
160
El Paso, TX 79925-3331
Phone (915) 779-1716

Other identifiers 1

IdentifierTypeStateIssuer
RS20070279OtherNMTRAINING

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131024000271 TX Practitioner - OtolaryngologyPractitioner - Allergy/Immunology 1759546880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Allergy/Immunology
Education
University of New Mexico School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CGN EpentGroup PAC ID 0446664114, 2 clinicians

Practice addresses (Care Compare)

5959 Gateway Blvd W
160 CGN Epent PLLC
El Paso, TX 79925-3315
Phone (915) 779-5866

Hospital & facility affiliations

  • The Hospitals of Providence - Memorial Campus Hospital, El Paso, TX, CCN 450002
  • Sierra Medical Center Hospital, El Paso, TX, CCN 450668
  • The Hospitals of Providence - East Campus Hospital, El Paso, TX, CCN 670047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RS20070279NMMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CGN Epent Otolaryngology CurrentSince Jan 1, 2021 Accepting new patients

Locations

201 Bartlett Dr
#A
El Paso, TX 79912
Phone (915) 779-5866

5959 Gateway Blvd W
Ste 160
El Paso, TX 79925
Phone (915) 779-5866

Interoperability endpoints

  • Direct secure messaging: jorgecontreras@epentapa.allscriptsdirect.net

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.

Hospital & facility affiliations 4

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": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377475200000",
    "number": "1033315411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 GATEWAY BLVD W",
            "address_2": "160",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799253331",
            "telephone_number": "915-779-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 GATEWAY BLVD W",
            "address_2": "160",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799253331",
            "telephone_number": "915-779-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONTRERAS",
        "first_name": "JORGE",
        "middle_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-22",
        "last_updated": "2013-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NM",
            "license": "RS20070279",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "P7624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAINING",
            "identifier": "RS20070279",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.