Individual provider Active NPI

Masayuki Iyanaga, MD

  • Emergency Medicine Physician
  • El Paso, TX
National Provider Identifier
1275766693
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
P7787 Issued in TX
Practice address
4815 Alameda Ave
El Paso, TX 79905-2705
Phone
(915) 215-4600
Fax
(915) 545-7338
NPI assigned
Sep 2, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X BP10031890 TX
Emergency Medicine Physician 207P00000X P7787 TX Primary
Emergency Medicine Physician 207P00000X MD.31104 AL

Addresses

Primary practice location

4815 Alameda Ave
El Paso, TX 79905-2705

Mailing address

440 Raynolds St # 51015
El Paso, TX 79905-1613
Phone (915) 215-4480

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
I20150616001212 TX Practitioner - Emergency Medicine 2769654953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2001
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) 215-6000

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.31104ALMDEmergency Medicine Physician
BP10031890TXMDStudent 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 Jun 1, 2015 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Jun 1, 2015 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

4800 Alberta Ave
#101
El Paso, TX 79905
Phone (915) 215-4478

Interoperability endpoints

  • Direct secure messaging: masayuki.iyanaga@direct.myhealthep.org

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": "1251849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1275766693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 RAYNOLDS ST # 51015",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799051613",
            "telephone_number": "915-215-4480",
            "fax_number": "915-215-5386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 ALAMEDA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052705",
            "telephone_number": "915-215-4600",
            "fax_number": "915-545-7338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IYANAGA",
        "first_name": "MASAYUKI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-02",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10031890",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "P7787",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "MD.31104",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.