Individual provider Active NPI

Jonathan C Estrada

  • Gerontology Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1376423137
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
1203061 Issued in TX
Practice address
1801 N Oregon St
El Paso, TX 79902-3524
Phone
(915) 213-0900
NPI assigned
Sep 3, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LG0600X 1203061 TX Primary

Addresses

Primary practice location

1801 N Oregon St
El Paso, TX 79902-3524

Mailing address

5539 N Mesa St
El Paso, TX 79912-5422
Phone (915) 213-0900

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
I20251219002609 TX Practitioner - Nurse Practitioner 6204321920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Asad Omar MD PAGroup PAC ID 4486938586, 9 clinicians

Practice addresses (Care Compare)

5539 N Mesa St
El Paso, TX 79912-5422
Phone (915) 213-0900

Hospital & facility affiliations

  • Las Palmas Medical Center a Campus of LPDS Healthc Hospital, El Paso, TX, CCN 450107
  • The Hospitals of Providence - East Campus Hospital, El Paso, TX, CCN 670047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1203061TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Asad Omar MD PA Multi-Specialty CurrentSince Dec 1, 2025 Accepting new patients
Revive Global PLLC Multi-Specialty CurrentSince Mar 1, 2026 Accepting new patients

Locations

1801 N Oregon St
El Paso, TX 79902
Phone (409) 883-9361

5539 N Mesa St
El Paso, TX 79912

1512 N Zaragoza Rd
Ste B
El Paso, TX 79936
Phone (915) 249-3900

Organizations & group practices 2

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 2

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": "1756857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1376423137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5539 N MESA ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799125422",
            "telephone_number": "915-213-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N OREGON ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799023524",
            "telephone_number": "915-213-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRADA",
        "first_name": "JONATHAN",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-03",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1203061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.