Individual provider Active NPI

Angela C CHI, D.M.D.

  • Oral and Maxillofacial Pathology Dentistry
  • El Paso, TX
National Provider Identifier
1255304606
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
37679 Issued in TX
Practice address
5001 El Paso Drive, MSC 24001
El Paso, TX 79905
Phone
(915) 215-5440
Fax
(915) 215-4678
NPI assigned
Feb 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 8608 SC
Oral and Maxillofacial Pathology Dentistry 1223P0106X 873 SC
Oral and Maxillofacial Pathology Dentistry 1223P0106X DS030650L PA
Oral and Maxillofacial Pathology Dentistry 1223P0106X 37679 TX Primary

Addresses

Primary practice location

5001 El Paso Drive, MSC 24001
El Paso, TX 79905

Mailing address

5548 Last Waltz Dr
El Paso, TX 79932-2052
Phone (915) 215-5440

Other identifiers 2

IdentifierTypeStateIssuer
P00147013OtherSCMEDICARE RAILROAD CARRIER
ZX0019MedicaidSC

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220816001650 TX Practitioner - Dentist 7911970074 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Tech University Health Sciences Center El PasoGroup PAC ID 7517864754, 306 clinicians

Practice addresses (Care Compare)

4815 Alameda Ave
El Paso, TX 79905-2705
Phone (915) 215-4956

Hospital & facility affiliations

  • University Medical Center of El Paso Hospital, El Paso, TX, CCN 450024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37679TXMDCounseling Psychologist
DS030650LPAMDOral and Maxillofacial Pathology Dentist
873SCMDOral and Maxillofacial Pathology Dentist
8608SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center El Paso Oral and Maxillofacial Pathology CurrentSince Jul 1, 2022 Accepting new patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Jul 1, 2022 Accepting new patients
Texas Tech University HSC at El WLH School of Dental Medicine PastSince May 25, 2021 Accepting new patients

Locations

4845 Alameda Ave
El Paso, TX 79905
Phone (915) 215-5700

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

4800 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5666

Organizations & group practices 4

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 3

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1255304606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5548 LAST WALTZ DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799322052",
            "telephone_number": "915-215-5440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 EL PASO DRIVE, MSC 24001",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79905",
            "telephone_number": "915-215-5440",
            "fax_number": "915-215-4678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHI",
        "first_name": "ANGELA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "SC",
            "license": "8608",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "SC",
            "license": "873",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "PA",
            "license": "DS030650L",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "TX",
            "license": "37679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER",
            "identifier": "P00147013",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX0019",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.