Individual provider Active NPI

Jacqueline Christine Nevarez, FNP-C

  • Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1144826199
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1012264 Issued in TX
Practice address
8041 N Mesa St Ste B2
El Paso, TX 79932-1666
Phone
(915) 307-3870
Fax
(915) 581-2926
NPI assigned
Dec 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 852800 TX
Family Nurse Practitioner 363LF0000X 1012264 TX
Nurse Practitioner 363L00000X 1012264 TX Primary

Addresses

Primary practice location

8041 N Mesa St Ste B2
El Paso, TX 79932-1666

Mailing address

4521 Bliss Ave
El Paso, TX 79903-3106
Phone (915) 309-8082

Other practice location 1

4801 Alberta Ave
El Paso, TX 79905-2707
Phone (915) 215-5300

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210701000015 TX Practitioner - Nurse Practitioner 3072914787 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Tech University Health Sciences Center El PasoGroup PAC ID 7517864754, 306 clinicians

Practice addresses (Care Compare)

4801 Alberta Ave
El Paso, TX 79905-2707
Phone (915) 215-5666

Hospital & facility affiliations

  • University Medical Center of El Paso Hospital, El Paso, TX, CCN 450024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
852800TXMDEmergency Registered Nurse
1012264TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center El Paso CurrentSince Aug 1, 2021 Accepting new patients
Emergency Services of Texas PA Nurse Practitioner CurrentSince Aug 1, 2022 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Aug 1, 2021 Accepting new patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients
El Paso County Hospital District Past Accepting new patients

Locations

1801 N Oregon St
El Paso, TX 79902
Phone (409) 883-9361

4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1144826199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4521 BLISS AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799033106",
            "telephone_number": "915-309-8082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8041 N MESA ST STE B2",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799321666",
            "telephone_number": "915-307-3870",
            "fax_number": "915-581-2926"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4801 Alberta Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052707",
            "country_code": "US",
            "telephone_number": "915-215-5300",
            "fax_number": "915-215-8606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEVAREZ",
        "first_name": "JACQUELINE",
        "middle_name": "CHRISTINE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-07",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "TX",
            "license": "852800",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1012264",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1012264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.