Individual provider Active NPI

Vid Fikfak, MD

  • Colon & Rectal Surgery Physician
  • El Paso, TX
National Provider Identifier
1245592484
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
S2771 Issued in TX
Practice address
4801 Alberta Ave
El Paso, TX 79905-2707
Phone
(915) 215-5300
Fax
(915) 215-8606
NPI assigned
Jun 13, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2019

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 BP10044088 TX
Colon & Rectal Surgery Physician 208C00000X S2771 TX Primary

Addresses

Primary practice location

4801 Alberta Ave
El Paso, TX 79905-2707

Mailing address

6550 Fannin St Ste 2307
Houston, TX 77030-2723
Phone (832) 472-6356

Other practice location 1

6565 Fannin St
Methodist Hospital
Houston, TX 77030
Phone (713) 441-1672

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
I20190928000193 TX Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 6709116031 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10044088TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Oct 1, 2019 Accepting new patients
El Paso County Hospital District CurrentSince Nov 1, 2021 Accepting new patients
El Paso County Hospital District CurrentSince Nov 1, 2021 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Oct 1, 2019 Accepting new patients
Texas Tech University Health Sciences Center Odessa Past Accepting new patients

Locations

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

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

Interoperability endpoints

  • Direct secure messaging: vid.fikfak@direct.myhealthep.org

Organizations & group practices 6

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": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1245592484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6550 FANNIN ST STE 2307",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302723",
            "telephone_number": "832-472-6356"
        },
        {
            "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": "915-215-5300",
            "fax_number": "915-215-8606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6565 Fannin St",
            "address_2": "METHODIST HOSPITAL",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "77030",
            "country_code": "US",
            "telephone_number": "713-441-1672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIKFAK",
        "first_name": "VID",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-13",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10044088",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "TX",
            "license": "S2771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.