Individual provider Active NPI

Jose Venzor III, M.D.

  • Allergy Physician
  • El Paso, TX
National Provider Identifier
1447254784
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
J2994 Issued in TX
Practice address
11410 Vista del Sol Dr
El Paso, TX 79936-5331
Phone
(915) 592-6269
Fax
(915) 592-8847
NPI assigned
Jun 1, 2005
Reactivated
Apr 21, 2006
Last updated
Aug 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X J2994 TX
Specialist 174400000X 92-370 NM
Allergy Physician 207KA0200X J2994 TX Primary

Addresses

Primary practice location

11410 Vista del Sol Dr
El Paso, TX 79936-5331

Mailing address

11410 Vista del Sol Dr
El Paso, TX 79936-5331
Phone (915) 592-6269

Other identifiers 2

IdentifierTypeStateIssuer
166563001MedicaidTX
113348004MedicaidTX

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
I20120502000705 TX Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 9638277312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
University of Texas Medical School at San Antonio, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11410 Vista del Sol Dr
El Paso, TX 79936-5331
Phone (915) 592-6269

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
92-370NMMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Allergy and Asthma Associates Specialist CurrentSince Oct 7, 2002 Accepting new patients

Locations

11410 Vista del Sol Dr
El Paso, TX 79936
Phone (915) 592-6269

11410 Vista del Sol Dr
Ste A
El Paso, TX 79936
Phone (915) 592-6269

6301 Northern Pass Dr
Bldg 8
El Paso, TX 79911
Phone (915) 585-1920

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.

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1447254784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11410 VISTA DEL SOL DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799365331",
            "telephone_number": "915-592-6269",
            "fax_number": "915-592-8847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11410 VISTA DEL SOL DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799365331",
            "telephone_number": "915-592-6269",
            "fax_number": "915-592-8847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENZOR",
        "first_name": "JOSE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "J2994",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NM",
            "license": "92-370",
            "primary": false
        },
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "TX",
            "license": "J2994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166563001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113348004",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.