Individual provider Active NPI

Michael A Ontiveros, D.C.

  • Chiropractor
  • El Paso, TX
National Provider Identifier
1174561351
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
9815 Issued in TX
Practice address
3800 N Mesa St
Ste C-1
El Paso, TX 79902-1538
Phone
(915) 838-1500
Fax
(915) 838-1700
NPI assigned
Jun 2, 2006
Last updated
Oct 1, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 9815 TX Primary

Addresses

Primary practice location

3800 N Mesa St
Ste C-1
El Paso, TX 79902-1538

Mailing address

3800 N Mesa St
Ste C-1
El Paso, TX 79902-1538
Phone (915) 838-1500

Other identifiers 2

IdentifierTypeStateIssuer
8V5180OtherTXBC/BS OF TEXAS
8F5089OtherMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040819000615 TX Practitioner - Chiropractic 3173596822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Desert Sun Chiropractic PLLCGroup PAC ID 6608974076, 3 clinicians

Practice addresses (Care Compare)

3800 N Mesa St
Suite C1
El Paso, TX 79902-1535
Phone (915) 838-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9815TXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Sun Chiropractic PLLC Chiropractor CurrentSince Apr 7, 2006 Accepting new patients

Locations

3800 N Mesa St
Ste C1
El Paso, TX 79902
Phone (915) 838-1500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1174561351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 N MESA ST",
            "address_2": "STE C-1",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799021538",
            "telephone_number": "915-838-1500",
            "fax_number": "915-838-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 N MESA ST",
            "address_2": "STE C-1",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799021538",
            "telephone_number": "915-838-1500",
            "fax_number": "915-838-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONTIVEROS",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "9815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF TEXAS",
            "identifier": "8V5180",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "8F5089",
            "state": null
        }
    ],
    "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 Oct 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.