Individual provider Active NPI

Uzodinma Raphael Dim, M.D.

  • Interventional Cardiology Physician
  • El Paso, TX
National Provider Identifier
1194990424
Registry record updated Mar 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
P0720 Issued in TX
Practice address
2200 George Dieter Drive
El Paso, TX 79936-3915
Phone
(915) 248-2434
Fax
(915) 248-2443
NPI assigned
Apr 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2016

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 230246 NY
Cardiovascular Disease Physician 207RC0000X P0720 TX
Clinical Cardiac Electrophysiology Physician 207RC0001X 230246 NY
Clinical Cardiac Electrophysiology Physician 207RC0001X P0720 TX
Interventional Cardiology Physician 207RI0011X 230246 NY
Interventional Cardiology Physician 207RI0011X P0720 TX Primary

Addresses

Primary practice location

2200 George Dieter Drive
El Paso, TX 79936-3915

Mailing address

2200 George Dieter Drive
El Paso, TX 79936-3915
Phone (915) 248-2434

Other identifiers 1

IdentifierTypeStateIssuer
286895201MedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111207000221 TX Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Cardiac ElectrophysiologyPractitioner - Interventional Cardiology 5395910145 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Cardiac Electrophysiology, Internal Medicine, Interventional Cardiology
Education
College of Medicine and Surgery, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2200 George Dieter Dr
El Paso, TX 79936-3915
Phone (915) 248-2434

Hospital & facility affiliations

  • Las Palmas Medical Center a Campus of LPDS Healthc Hospital, El Paso, TX, CCN 450107

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting18
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
230246NYMDCardiovascular Disease Physician

Organizations & group practices 2

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 1

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": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1194990424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 GEORGE DIETER DRIVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799363915",
            "telephone_number": "915-248-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 GEORGE DIETER DRIVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799363915",
            "telephone_number": "915-248-2434",
            "fax_number": "915-248-2443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIM",
        "first_name": "UZODINMA",
        "middle_name": "RAPHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-28",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "230246",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "P0720",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NY",
            "license": "230246",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "TX",
            "license": "P0720",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NY",
            "license": "230246",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "P0720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286895201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.