Individual provider Active NPI

Juan Emmanuel Anzures Jr., NP

  • Psychiatric/Mental Health Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1417464736
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP136174 Issued in TX
Practice address
725 S. Mesa Hills Dr.
BLDG 1, Ste 1
El Paso, TX 79912
Phone
(915) 887-3410
Fax
(915) 351-4467
NPI assigned
Jan 8, 2018
Last updated
Mar 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP136174 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP136174 TX Primary

Addresses

Primary practice location

725 S. Mesa Hills Dr.
BLDG 1, Ste 1
El Paso, TX 79912

Mailing address

201 E Main Dr Ste 600
El Paso, TX 79901-1385
Phone (915) 887-3410

Other practice location 1

201 W Main Dr # 600
El Paso, TX 79901-1126
Phone (915) 887-3410

Other practice location 2

2400 Trawood Dr
El Paso, TX 79936-4168
Phone (915) 599-6735

Other practice location 3

1551 Montana Ave
El Paso, TX 79902-5668
Phone (915) 747-3510

Other identifiers 1

IdentifierTypeStateIssuer
384199101MedicaidTX

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
I20180402000613 TX Practitioner - Nurse Practitioner 4486916483 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
El Paso Community MHMRGroup PAC ID 3476532383, 54 clinicians

Practice addresses (Care Compare)

725 S Mesa Hills Dr BLDG 1
1 Emergence Health Network
El Paso, TX 79912-5568
Phone (915) 887-3410

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP136174TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa of Texas PLLC CurrentSince Aug 25, 2018 Accepting new patients
El Paso Community MHMR Single Specialty Current Accepting new patients
Vpa of Texas PLLC Single Specialty Current Accepting new patients
Vpa of Texas PLLC CurrentSince Aug 25, 2018 Accepting new patients
El Paso Community MHMR Single Specialty Past Accepting new patients

Locations

10737 Gateway Blvd W
Ste 250
El Paso, TX 79935
Phone (915) 242-0555

1477 Lomaland Dr
Ste E7
El Paso, TX 79935
Phone 9155996690 ext. 13054

1551 Montana Ave
El Paso, TX 79902
Phone (915) 341-6909

1600 Montana Ave
El Paso, TX 79902
Phone (915) 877-3410

1601 E Yandell Dr
El Paso, TX 79902
Phone (915) 599-4900

201 E Main Dr
Ste 600
El Paso, TX 79901
Phone (915) 887-3419

2400 Trawood Dr
Ste 301
El Paso, TX 79936
Phone (915) 599-6735

725 S Mesa Hills Dr
Bldg 1
El Paso, TX 79912
Phone (915) 228-8128

8500 Boeing Dr
El Paso, TX 79925
Phone (915) 242-0555

8730 Boeing Dr
El Paso, TX 79925
Phone (915) 599-6600

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

Organizations & group practices 5

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": "1515369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1417464736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E MAIN DR STE 600",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799011385",
            "telephone_number": "915-887-3410",
            "fax_number": "915-351-3643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S. MESA HILLS DR.",
            "address_2": "BLDG 1, STE 1",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79912",
            "telephone_number": "915-887-3410",
            "fax_number": "915-351-4467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 W Main Dr # 600",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799011126",
            "country_code": "US",
            "telephone_number": "915-887-3410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2400 Trawood Dr",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799364168",
            "country_code": "US",
            "telephone_number": "915-599-6735",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1551 Montana Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799025668",
            "country_code": "US",
            "telephone_number": "915-747-3510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANZURES",
        "first_name": "JUAN",
        "middle_name": "EMMANUEL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-08",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP136174",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP136174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "384199101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.