Individual provider Active NPI

Becky Bea Personett, M.D.

  • Family Medicine Physician
  • El Paso, TX
National Provider Identifier
1104907120
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J0785 Issued in TX
Practice address
4421 Edgar Park Ave
El Paso, TX 79904-2807
Phone
(915) 757-2874
Fax
(915) 751-3240
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
Yes

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 J0785 TX Primary

Addresses

Primary practice location

4421 Edgar Park Ave
El Paso, TX 79904-2807

Mailing address

4421 Edgar Park Ave
El Paso, TX 79904-2807
Phone (915) 757-2874

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
I20031121000217 TX Practitioner - Family Practice 3274437256 Practice locations: El Paso, TX

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J0785TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Imaging Services of El Paso Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104907120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4421 EDGAR PARK AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799042807",
            "telephone_number": "915-757-2874",
            "fax_number": "915-751-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4421 EDGAR PARK AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799042807",
            "telephone_number": "915-757-2874",
            "fax_number": "915-751-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSONETT",
        "first_name": "BECKY",
        "middle_name": "BEA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J0785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.