Individual provider Active NPI

Brent D Michener, DO

  • Surgery Physician
  • El Paso, TX
National Provider Identifier
1417165002
Registry record updated Mar 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
M7798 Issued in TX
Practice address
3270 Joe Battle Blvd
Suite 205
El Paso, TX 79938-2639
Phone
(915) 855-2400
Fax
(915) 855-2401
NPI assigned
May 18, 2007
Last updated
Mar 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X M7798 TX Primary

Addresses

Primary practice location

3270 Joe Battle Blvd
Suite 205
El Paso, TX 79938-2639

Mailing address

3270 Joe Battle Blvd
Suite 205
El Paso, TX 79938-2639
Phone (915) 855-2400

Other identifiers 1

IdentifierTypeStateIssuer
M7798OtherTXTEXAS MEDICAL LICENSE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080215000466 TX Practitioner - General Surgery 5294818100 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
El Paso Colon and Rectal Clinic PA Surgery CurrentSince Dec 1, 2011 Accepting new patients
Sharif Surgical PLLC CurrentSince Nov 30, 2022 Accepting new patients

Locations

900 Chelsea St
El Paso, TX 79903
Phone (915) 544-4042

909 9th Ave
Ste 205
Fort Worth, TX 76104
Phone (817) 332-0786

909 9th Ave
Ste 401
Ft Worth, TX 76104
Phone (817) 332-0786

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25904/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362960000000",
    "number": "1417165002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3270 JOE BATTLE BLVD",
            "address_2": "SUITE 205",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799382639",
            "telephone_number": "915-855-2400",
            "fax_number": "915-855-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3270 JOE BATTLE BLVD",
            "address_2": "SUITE 205",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799382639",
            "telephone_number": "915-855-2400",
            "fax_number": "915-855-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHENER",
        "first_name": "BRENT",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2013-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "M7798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL LICENSE",
            "identifier": "M7798",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.