Individual provider Active NPI

Thomas Gerard Tullius Jr., MD

  • Vascular & Interventional Radiology Physician
  • El Paso, TX
National Provider Identifier
1467794818
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
R9303 Issued in TX
Practice address
4815 Alameda Ave
El Paso, TX 79905-2705
Phone
(915) 544-1200
NPI assigned
Mar 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD2019-0225 NM
Diagnostic Radiology Physician 2085R0202X R9303 TX
Vascular & Interventional Radiology Physician 2085R0204X MD2019-0225 NM
Vascular & Interventional Radiology Physician 2085R0204X R9303 TX Primary

Addresses

Primary practice location

4815 Alameda Ave
El Paso, TX 79905-2705

Mailing address

PO Box 202479
Dallas, TX 75320-2479

Other practice location 1

2669 Scenic Dr
Alamogordo, NM 88310-8734
Phone (575) 434-7700

Other practice location 2

8020 Constitution Pl NE Ste 202
Albuquerque, NM 87110
Phone (505) 998-3096

Other identifiers 1

IdentifierTypeStateIssuer
52074366MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190711001126 NM Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 0840592622 Reassigns benefits to 2 organizations
I20200131000142 TX Practitioner - Diagnostic Radiology 0840592622 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Texas Tech University Health Science Center School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El Paso County Hospital DistrictGroup PAC ID 2365431509, 208 clinicians

Practice addresses (Care Compare)

4815 Alameda Ave
El Paso, TX 79905-2705
Phone (915) 521-7902

Hospital & facility affiliations

  • University Medical Center of El Paso Hospital, El Paso, TX, CCN 450024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD2019-0225NMMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
El Paso County Hospital District CurrentSince Jan 1, 2020 Accepting new patients
Otero County Hospital Association CurrentSince Jan 1, 2024 Accepting new patients
Otero County Hospital Association CurrentSince Jan 1, 2024 Accepting new patients
KND Development 59 LLC CurrentSince Aug 1, 2019 Accepting new patients
KND Development 59, LLC CurrentSince Aug 1, 2019 Accepting new patients
El Paso County Hospital District CurrentSince Jan 1, 2020 Accepting new patients

Locations

2539 Medical Dr
Ste 101
Alamogordo, NM 88310
Phone (505) 434-1353

2669 Scenic Dr
Alamogordo, NM 88310
Phone (505) 439-6100

8020 Constitution Pl NE
Ste 101
Albuquerque, NM 87110
Phone (505) 998-1317

8020 Constitution Pl NE
Ste 202
Albuquerque, NM 87110
Phone (505) 559-5628

700 High St NE
Albuquerque, NM 87102
Phone (505) 242-4444

4815 Alameda Ave
El Paso, TX 79905
Phone (915) 215-6000

Organizations & group practices 7

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 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": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1467794818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 202479",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753202479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 ALAMEDA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052705",
            "telephone_number": "915-544-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2669 Scenic Dr",
            "address_purpose": "LOCATION",
            "city": "Alamogordo",
            "state": "NM",
            "postal_code": "883108734",
            "country_code": "US",
            "telephone_number": "575-434-7700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8020 Constitution Pl NE Ste 202",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "87110",
            "country_code": "US",
            "telephone_number": "505-998-3096",
            "fax_number": "505-998-3100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TULLIUS",
        "first_name": "THOMAS",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-25",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NM",
            "license": "MD2019-0225",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "R9303",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NM",
            "license": "MD2019-0225",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "R9303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52074366",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.