Individual provider Active NPI

Jorge Adan Vazquez, APRN-CNP

  • Family Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1376313775
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1136691 Issued in TX
Practice address
825 Desert Moon Dr
El Paso, TX 79928-6572
Phone
(915) 503-7043
NPI assigned
Jan 5, 2024
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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 1136691 TX Primary

Addresses

Primary practice location

825 Desert Moon Dr
El Paso, TX 79928-6572

Mailing address

825 Desert Moon Dr
El Paso, TX 79928-6572
Phone (915) 503-7043

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
I20241029004486 TX Practitioner - Nurse Practitioner 2668905662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sun City Neuromuscular Rehabilitation PLLCGroup PAC ID 4385970896, 4 clinicians

Practice addresses (Care Compare)

1600 E Cliff Dr
El Paso, TX 79902-5130
Phone (915) 298-7222

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sun City Neuromuscular Rehabilitation PLLC CurrentSince Oct 3, 2024 Accepting new patients

Locations

1395 George Dieter Dr
El Paso, TX 79936
Phone (915) 298-7225

1600 E Cliff Dr
El Paso, TX 79902
Phone 80053261517044

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1704412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1376313775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 DESERT MOON DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799286572",
            "telephone_number": "915-503-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 DESERT MOON DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799286572",
            "telephone_number": "915-503-7043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "JORGE",
        "middle_name": "ADAN",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-05",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1136691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.