Individual provider Active NPI

Crystal M Carbajal, FNP

  • Family Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1366878043
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP124964 Issued in TX
Practice address
1211 E Cliff Dr
El Paso, TX 79902-4734
Phone
(915) 591-6226
Fax
(915) 308-9433
NPI assigned
Sep 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP124964 TX Primary

Addresses

Primary practice location

1211 E Cliff Dr
El Paso, TX 79902-4734

Mailing address

6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168
Phone (407) 533-6836

Other identifiers 2

IdentifierTypeStateIssuer
333643002MedicaidTX
341369YLPSOtherTXWELLMED PTAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address crystal.carbajal.1@29601.direct.athenahealth.com Direct

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
I20140424001351 TX Practitioner - Nurse Practitioner 2668605841 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conviva Medical Center Management of Texas, P.a.Group PAC ID 8729302278, 146 clinicians

Practice addresses (Care Compare)

1211 E Cliff Dr
El Paso, TX 79902-4734
Phone (915) 591-6226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP124964TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Conviva Medical Center Management of Texas, P.a. CurrentSince Jan 1, 2021 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jan 25, 2026 Accepting new patients
Centerwell Senior Primary Care (SC) PC CurrentSince Jan 1, 2021 Accepting new patients

Locations

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

1211 E Cliff Dr
El Paso, TX 79902
Phone (915) 533-8147

1211 E Cliff Dr
#B
El Paso, TX 79902
Phone (915) 591-6226

260 US Highway 181 N
Floresville, TX 78114
Phone (830) 393-8222

18414 US Highway 281 N
Ste 104
San Antonio, TX 78259
Phone (210) 354-0800

Interoperability endpoints

  • Direct secure messaging: crystal.carbajal.1@29601.direct.athenahealth.com

Organizations & group practices 3

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": "1380067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1366878043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168",
            "telephone_number": "407-533-6836",
            "fax_number": "407-770-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 E CLIFF DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799024734",
            "telephone_number": "915-591-6226",
            "fax_number": "915-308-9433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBAJAL",
        "first_name": "CRYSTAL",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-25",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP124964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "333643002",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED PTAN",
            "identifier": "341369YLPS",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crystal.carbajal.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1211 E Cliff Dr",
            "city": "El Paso",
            "state": "TX",
            "country_code": "US",
            "postal_code": "799024734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.