NPIMap

Organization Active NPI

Ysleta del Sur Pueblo Community Health Center

  • Federal Public Health Clinic/Center
  • El Paso, TX
National Provider Identifier
1144390147
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federal Public Health Clinic/CenterTaxonomy code 261QP0904X
Legal business name
YSLETA DEL SUR PUEBLO COMMUNITY HEALTH CENTER
Practice address
9473 Socorro Rd
El Paso, TX 79907
Phone
(915) 860-6113
Fax
(915) 860-6166
NPI assigned
Nov 8, 2006
Last updated
Nov 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Authorized official

Name
Mr. Martin Lopez
Title
HHS Director
Phone
(915) 858-1076

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 17718 TX
Clinic/Center 261Q00000X NU
Federal Public Health Clinic/Center 261QP0904X NU Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 1603-1603A TX
Secured Medical Transport (VAN) 343800000X NU

Addresses

Primary practice location

9473 Socorro Rd
El Paso, TX 79907

Mailing address

9473 Socorro Rd
El Paso, TX 79907-5619
Phone (915) 858-1076

Other identifiers 2

IdentifierTypeStateIssuer
4480063-01MedicaidTX
092524001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071116000507 TX Part B Supplier - Clinic/Group Practice 7517055015 Receives reassigned benefits from 19 practitioners
Practice locations: El Paso, TX

National Provider Directory

National Provider Directory
Tax ID family
Ysleta del Sur Pueblo3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9180 Socorro Rd
Ste 400
El Paso, TX 79907
Phone (915) 860-6180

9314 Juanchido Ln
Ysleta del Sur Pueblo, TX 79907
Phone (915) 858-1076

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1144390147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9473 SOCORRO RD",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799075619",
            "telephone_number": "915-858-1076",
            "fax_number": "915-860-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9473 SOCORRO RD",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79907",
            "telephone_number": "915-860-6113",
            "fax_number": "915-860-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YSLETA DEL SUR PUEBLO COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "HHS DIRECTOR",
        "authorized_official_telephone_number": "915-858-1076",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "17718",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP0904X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, Federal",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "TX",
            "license": "1603-1603A",
            "primary": false
        },
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4480063-01",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "092524001",
            "state": "TX"
        }
    ],
    "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 Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.