NPIMap

Individual provider Active NPI

Ezhil Panneerselvam, MD

  • Internal Medicine Physician
  • El Paso, TX
National Provider Identifier
1235794546
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
T9768 Issued in TX
Practice address
4801 Alberta Ave
El Paso, TX 79905-2707
Phone
(843) 597-3010
NPI assigned
May 2, 2019
Last updated
Jun 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X T9768 TX Primary

Addresses

Primary practice location

4801 Alberta Ave
El Paso, TX 79905-2707

Mailing address

4801 Alberta Ave
El Paso, TX 79905-2707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230515000763 TX Practitioner - Internal Medicine 1355707589 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mobilemed, PLLCGroup PAC ID 0446685051, 12 clinicians
El Paso County Hospital DistrictGroup PAC ID 2365431509, 208 clinicians

Practice addresses (Care Compare)

1201 E Schuster Ave
Suite 1a
El Paso, TX 79902-4646
Phone (915) 307-4669

4815 Alameda Ave
El Paso, TX 79905-2705
Phone (915) 521-7902

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.2 of 100Reported as group
Quality
100
Improvement activities
40
Cost
53.99

Merit-based Incentive Payment System (MIPS)

Final score
92 of 100Reported as group
Quality
90.22
Promoting interoperability
95
Improvement activities
40
Cost
75.52

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mobilemed, PLLC Internal Medicine CurrentSince Jul 1, 2023 Accepting new patients
El Paso County Hospital District CurrentSince Jan 26, 2023 Accepting new patients
El Paso County Hospital District CurrentSince Jan 26, 2023 Accepting new patients
West Wharton County Hospital District Past Accepting new patients
West Wharton County Hospital District Past Accepting new patients
El Paso IV Enterprises, LLC Past Accepting new patients
Socorro Health Care, LLC Past Accepting new patients

Locations

1201 E Schuster Ave
Ste 1A
El Paso, TX 79902
Phone (915) 229-6448

4815 Alameda Ave
El Paso, TX 79905
Phone (915) 215-6000

4849 N Mesa St
Ste 201
El Paso, TX 79912

Interoperability endpoints

  • Direct secure messaging: ezhil.panneerselvam@direct.myhealthep.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ignite Medical Resort El Paso, LLCEl Paso, TX, CCN 676428 Skilled nursing facility Adp of the SNF Dec 1, 2024

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1235794546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 ALBERTA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 ALBERTA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052707",
            "telephone_number": "843-597-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANNEERSELVAM",
        "first_name": "EZHIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-02",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T9768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.