Individual provider Active NPI

Manuel L. Acosta-Corrales, M.D.

  • Surgery Physician
  • El Paso, TX
National Provider Identifier
1083615595
Registry record updated Nov 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
E3635 Issued in TX
Practice address
1655 Mosswood St
El Paso, TX 79935-3435
Phone
(915) 591-7700
Fax
(915) 591-3170
NPI assigned
Aug 9, 2005
Last updated
Nov 27, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X E3635 TX Primary

Addresses

Primary practice location

1655 Mosswood St
El Paso, TX 79935-3435

Mailing address

1655 Mosswood St
El Paso, TX 79935-3435
Phone (915) 591-7700

Other identifiers 1

IdentifierTypeStateIssuer
031804001MedicaidTX

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
I20090224000319 TX Practitioner - General Surgery 0345305462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1969
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10175 Gateway W Blvd
Suite 220
El Paso, TX 79925-7647

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E3635TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
El Paso del Norte Surgical Group, PA Surgery CurrentSince Aug 15, 2008 Accepting new patients

Locations

10175 Gateway Blvd W
Ste 220
El Paso, TX 79925
Phone (915) 351-1444

1655 Mosswood St
El Paso, TX 79935
Phone (915) 591-7700

Interoperability endpoints

  • Direct secure messaging: manuelacosta@rgs.direct.emds.com

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, 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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1083615595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1655 MOSSWOOD ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799353435",
            "telephone_number": "915-591-7700",
            "fax_number": "915-591-3170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 MOSSWOOD ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799353435",
            "telephone_number": "915-591-7700",
            "fax_number": "915-591-3170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACOSTA-CORRALES",
        "first_name": "MANUEL",
        "middle_name": "L.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "E3635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031804001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.