Active NPI
Manas Vaibhav Pustake, MD
- Student in an Organized Health Care Education/Training Program
- El Paso, TX
National Provider Identifier
1093564874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- BP10090533
- Practice address
- 4800 Alberta Avenue MSC 51009
El Paso, TX 79905 - Phone
- (915) 215-4116
- NPI assigned
- May 15, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | BP10090533 | TX | Primary |
Addresses
Primary practice location
4800 Alberta Avenue MSC 51009
El Paso, TX 79905
Mailing address
165 W Castellano Dr
Apt 3307
El Paso, TX 79912
Phone (915) 299-9401
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BP10090533 | TX | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721606400000",
"number": "1093564874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "165 W CASTELLANO DR",
"address_2": "APT 3307",
"city": "EL PASO",
"state": "TX",
"postal_code": "79912",
"telephone_number": "915-299-9401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 ALBERTA AVENUE MSC 51009",
"city": "EL PASO",
"state": "TX",
"postal_code": "79905",
"telephone_number": "915-215-4116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUSTAKE",
"first_name": "MANAS",
"middle_name": "VAIBHAV",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-15",
"last_updated": "2024-07-22",
"certification_date": "2024-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "TX",
"license": "BP10090533",
"primary": true
}
],
"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 Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.