Individual provider Active NPI

Ulysses Urquidi, M.D.

  • Family Medicine Physician
  • Fabens, TX
National Provider Identifier
1245288109
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L4774 Issued in TX
Practice address
600 N.E. 4TH St.
Fabens, TX 79838-7983
Phone
(915) 765-5119
Fax
(915) 765-5126
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L4774 TX Primary

Addresses

Primary practice location

600 N.E. 4TH St.
Fabens, TX 79838-7983

Mailing address

8524 Mountain Ash Dr
El Paso, TX 79904-2442
Phone (915) 783-8162

Other identifiers 1

IdentifierTypeStateIssuer
152119702MedicaidTX

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
I20051219000303 TX Practitioner - Family Practice 7012938087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas Tech University Health Science Center School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

600 NE 4TH St
Fabens, TX 79838-0697

600 PFC Fernando Gutierrez St
Fabens, TX 79838-0697
Phone (915) 765-5119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L4774TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gamut Medical Group PA Family Medicine CurrentSince Mar 30, 2011 Accepting new patients
Planned Parenthood Center of El Paso Family Medicine Past Accepting new patients
Planned Parenthood Center of El Paso Family Medicine Past Accepting new patients
El Paso County Hospital District PastSince Jan 14, 2024 Accepting new patients
Texas Tech University Health Sciences Center El Paso PastSince May 16, 2021 Accepting new patients

Locations

1900 Denver Ave
El Paso, TX 79902
Phone (915) 787-6265

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.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1245288109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8524 MOUNTAIN ASH DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799042442",
            "telephone_number": "915-783-8162",
            "fax_number": "915-351-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N.E. 4TH ST.",
            "city": "FABENS",
            "state": "TX",
            "postal_code": "798387983",
            "telephone_number": "915-765-5119",
            "fax_number": "915-765-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URQUIDI",
        "first_name": "ULYSSES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L4774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152119702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fabens, TX

Sources for this page

Verify at the official NPI Registry.