Ildefonso Carrera, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2097261 Issued in TX

Practice address

10188 Socorro Rd
El Paso, TX 79927-2322

Phone

(915) 479-1473

Fax

(915) 440-3148

NPI assigned

Apr 8, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Serenity Equine and Therapeutic Services. Inc

  • Physical Therapy Clinic/Center
  • El Paso, TX
  • NPI 1841971868
  NPD Authorized official
• Relief Service LLC

  • Physical Therapist
  • Socorro, TX
  • NPI 1881250215

  Multi-Specialty

  NPD (past) Authorized official
• Alianza Community Care Services LLC

  • Community Health/Public Health Clinical Nurse Specialist
  • El Paso, TX
  • NPI 1376478479
  NPD

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1124607825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 PVT JUAN GARCIA RD",
            "city": "SOCORRO",
            "state": "TX",
            "postal_code": "799271323",
            "telephone_number": "915-479-1473",
            "fax_number": "915-440-3148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10188 SOCORRO RD",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799272322",
            "telephone_number": "915-479-1473",
            "fax_number": "915-440-3148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRERA",
        "first_name": "ILDEFONSO",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-08",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2097261",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1881250215",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "reliefservicesllc3526@gmial.com",
            "affiliation": "N",
            "endpointDescription": "Company email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10188 Socorro Rd",
            "city": "El Paso",
            "state": "TX",
            "country_code": "US",
            "postal_code": "799272322",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Victor Carrasco
• Arleth L Carreon
• Ashley Carreon
• Tabitha Anne Carreon, PHARM D
• Brianna Carrera
• Kevin Carrera
• Wendy Carrera
• Alexa Anahi Carreto
• Mia Carreto
• Beatriz Carrillo Blanco, DNP, FNP-C, PMHNP-BC

• Physical Therapy Assistant in El Paso, TX
• Providers in El Paso, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.