Active NPI
Mostafa Mohamed M I Eysha, MD
- Internal Medicine Physician
- El Paso, TX
National Provider Identifier
1114772290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- BP10090523
- Practice address
- 4801 Alberta Ave # Msc51009
El Paso, TX 79905-2707 - Phone
- (915) 215-4116
- NPI assigned
- Apr 22, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | BP10090523 | TX | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
4801 Alberta Ave # Msc51009
El Paso, TX 79905-2707
Mailing address
4801 Alberta Ave # Msc51009
El Paso, TX 79905-2707
Phone (915) 215-4116
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 |
|---|---|---|---|
| BP10090523 | TX | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719273600000",
"number": "1114772290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4801 ALBERTA AVE # MSC51009",
"city": "EL PASO",
"state": "TX",
"postal_code": "799052707",
"telephone_number": "915-215-4116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4801 ALBERTA AVE # MSC51009",
"city": "EL PASO",
"state": "TX",
"postal_code": "799052707",
"telephone_number": "915-215-4116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EYSHA",
"first_name": "MOSTAFA",
"middle_name": "MOHAMED M I",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-04-22",
"last_updated": "2024-06-25",
"certification_date": "2024-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "BP10090523",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Paso, TX
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- Ez Dental Care, PLLC
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- Ez Scripts LLC (Healthy City Pharmacy Long Term Care)
- Chigolum Chidinma Eze, MD
- Obiageli Chinaka Ezewuiro, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.