Organization Active NPI

Jorge Natividad Avila Jr MD PA

  • Psychiatry Physician
  • El Paso, TX
National Provider Identifier
1487163176
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
JORGE NATIVIDAD AVILA JR MD PA
Practice address
125 W Hague Rd Ste 250
El Paso, TX 79902-5814
Phone
(915) 219-4100
NPI assigned
Sep 25, 2017
Last updated
Oct 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Authorized official

Name
Jorge Avila, MDNPI 1255538187
Title
Owner
Phone
(818) 749-4743

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

125 W Hague Rd Ste 250
El Paso, TX 79902-5814

Mailing address

1500 Bellview CT
El Paso, TX 79912-2652
Phone (915) 219-4100

Other practice location 1

1900 Denver Ave
El Paso, TX 79902-3008
Phone (915) 544-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171115002202 TX Part B Supplier - Clinic/Group Practice 3274899885 Receives reassigned benefits from 2 practitioners
Practice locations: El Paso, TX

National Provider Directory

National Provider Directory

Locations

1250 E Cliff Dr
Ste 5D
El Paso, TX 79902
Phone (915) 219-4100

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1506297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1487163176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 BELLVIEW CT",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799122652",
            "telephone_number": "915-219-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 W HAGUE RD STE 250",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799025814",
            "telephone_number": "915-219-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Denver Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799023008",
            "country_code": "US",
            "telephone_number": "915-544-4000",
            "fax_number": "915-544-8750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JORGE NATIVIDAD AVILA JR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-25",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "AVILA",
        "authorized_official_first_name": "JORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-749-4743",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.