Individual provider Active NPI

Michael Harrison Janes, M.D.

  • Family Medicine Physician
  • Ysleta del Sur Pueblo, TX
National Provider Identifier
1487181129
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
S7247 Issued in TX
Practice address
9314 Juanchido LN
Ysleta del Sur Pueblo, TX 79907-6832
Phone
(915) 858-1076
Fax
(915) 858-2367
NPI assigned
May 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TX
Family Medicine Physician 207Q00000X S7247 TX Primary

Addresses

Primary practice location

9314 Juanchido LN
Ysleta del Sur Pueblo, TX 79907-6832

Mailing address

1402 W Avenue H
Temple, TX 76504-5342
Phone (254) 771-8401

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
I20210218000025 TX Practitioner - Family Practice 5799057196 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
El Paso Physical Therapy Specialists LLCGroup PAC ID 1355762774, 106 clinicians
El Paso Therapy Services, Inc.Group PAC ID 4587626106, 99 clinicians
Ysleta del Sur Pueblo Community Health CenterGroup PAC ID 7517055015, 8 clinicians

Practice addresses (Care Compare)

6151 Dew Dr
Suite 300
El Paso, TX 79912-3912
Phone (915) 581-9606

9473 Socorro Rd
El Paso, TX 79907-5619
Phone (915) 858-1076

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ysleta del Sur Pueblo Community Health Center CurrentSince Nov 12, 2020 Accepting new patients

Locations

9314 Juanchido Ln
Ysleta del Sur Pueblo, TX 79907
Phone (915) 858-1076

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1487181129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 W AVENUE H",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765045342",
            "telephone_number": "254-771-8401",
            "fax_number": "254-771-8407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9314 JUANCHIDO LN",
            "city": "YSLETA DEL SUR PUEBLO",
            "state": "TX",
            "postal_code": "799076832",
            "telephone_number": "915-858-1076",
            "fax_number": "915-858-2367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANES",
        "first_name": "MICHAEL",
        "middle_name": "HARRISON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-12",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S7247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ysleta del Sur Pueblo, TX

Sources for this page

Verify at the official NPI Registry.