Active NPI
Nichole E Lugo, PA
- Physician Assistant
- El Paso, TX
National Provider Identifier
1265437347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA03694
- Practice address
- 11040 Vista del Sol Dr Ste C
El Paso, TX 79935-4314 - Phone
- (915) 591-7704
- Fax
- (915) 591-7734
- NPI assigned
- Jun 16, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA03694 | TX | Primary |
Addresses
Primary practice location
11040 Vista del Sol Dr Ste C
El Paso, TX 79935-4314
Mailing address
11040 Vista del Sol Dr Ste C
El Paso, TX 79935-4314
Phone (915) 591-7704
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 182328802 | Medicaid | TX | |
| 68325886 | Medicaid | NM | |
| 182328801 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA03694 | TX | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physicians and Allied Health Professionals Group, PA | Past | Accepting new patients | |
| El Paso Physician Group PA | Physician Assistant | Past | Accepting new patients |
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.
-
- Internal Medicine Physician
- El Paso, TX
- NPI 1679524011
Physician Assistant
-
- Family Medicine Physician
- Dallas, TX
- NPI 1528011814
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277337600000",
"number": "1265437347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11040 VISTA DEL SOL DR STE C",
"city": "EL PASO",
"state": "TX",
"postal_code": "799354314",
"telephone_number": "915-591-7704",
"fax_number": "915-591-7734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11040 VISTA DEL SOL DR STE C",
"city": "EL PASO",
"state": "TX",
"postal_code": "799354314",
"telephone_number": "915-591-7704",
"fax_number": "915-591-7734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUGO",
"first_name": "NICHOLE",
"middle_name": "E",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-16",
"last_updated": "2010-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA03694",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "182328802",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "68325886",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "182328801",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in El Paso, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.