Individual provider Active NPI

Brenna Nicole Umino, PA

  • Physician Assistant
  • El Paso, TX
National Provider Identifier
1285080069
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10910 Issued in TX
Practice address
4815 Alameda Ave
El Paso, TX 79905-2705
Phone
(915) 215-4600
Fax
(915) 545-7338
NPI assigned
May 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA10910 TX Primary

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

Other practice location 1

1801 N Oregon St
El Paso, TX 79902-3524
Phone (915) 521-1200

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170405000475 TX Practitioner - Physician Assistant 5395021471 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Services of Texas PAGroup PAC ID 7517289291, 57 clinicians

Practice addresses (Care Compare)

1801 N Oregon St
Las Palmas Med Ctr
El Paso, TX 79902-3524
Phone (915) 521-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA10910TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center El Paso Physician Assistant CurrentSince Dec 1, 2021 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Dec 1, 2021 Accepting new patients
HCN Ep Horizon City, LLC Past Accepting new patients

Locations

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

Organizations & group practices 8

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": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1285080069",
    "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": [
        {
            "address_1": "1801 N Oregon St",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799023524",
            "country_code": "US",
            "telephone_number": "915-521-1200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UMINO",
        "first_name": "BRENNA",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-10",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.