NPIMap

Organization Active NPI

Texas Tech University Health Sciences Center El Paso

  • Diagnostic Radiology Physician
  • El Paso, TX
National Provider Identifier
1316901135
Registry record updated Nov 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER EL PASO
Practice address
4815 Alameda Ave
El Paso, TX 79905-2705
Phone
(915) 545-8823
Fax
(915) 545-9799
NPI assigned
Apr 17, 2006
Last updated
Nov 6, 2019By the provider in NPPES
Organization subpart
No

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

Authorized official

Name
Sue Fuciarelli
Title
Vice President for Finance and Admi
Phone
(915) 215-4300

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X NU
Nuclear Radiology Physician 2085N0904X TX
Pediatric Radiology Physician 2085P0229X TX
Diagnostic Radiology Physician 2085R0202X TX Primary
Vascular & Interventional Radiology Physician 2085R0204X NU
Diagnostic Ultrasound Physician 2085U0001X TX

Addresses

Primary practice location

4815 Alameda Ave
El Paso, TX 79905-2705

Mailing address

PO Box 9520
El Paso, TX 79995-9520
Phone (915) 545-9795

Other practice location 1

2000 B Transmountain Road
El Paso, TX 79911
Phone (915) 215-8408

Other identifiers 3

IdentifierTypeStateIssuer
CC1842OtherNMRAILROAD MEDICARE GROUP #
G0953OtherNMNM MEDICAID GROUP NUMBER
084602402MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031216000806 TX Part B Supplier - Clinic/Group Practice 7517864754 Receives reassigned benefits from 864 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: El Paso, TX; Alpine, TX

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Texas Tech University El Paso27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 32

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572998400000",
    "number": "1316901135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9520",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799959520",
            "telephone_number": "915-545-9795",
            "fax_number": "915-545-9799"
        },
        {
            "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": "915-545-8823",
            "fax_number": "915-545-9799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 B Transmountain Road",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "79911",
            "country_code": "US",
            "telephone_number": "915-215-8408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER EL PASO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-17",
        "last_updated": "2019-11-06",
        "status": "A",
        "authorized_official_last_name": "FUCIARELLI",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "VICE PRESIDENT FOR FINANCE AND ADMI",
        "authorized_official_telephone_number": "915-215-4300"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP #",
            "identifier": "CC1842",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NM  MEDICAID GROUP NUMBER",
            "identifier": "G0953",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084602402",
            "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 Nov 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.