Henry Russell Hutteman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA04298 Issued in TX

Practice address

10720 N Loop Dr
Ste a-6
Socorro, TX 79927-4409

Phone

(915) 858-0500

NPI assigned

Apr 24, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Southwest HCP Access PA

  • Allergy Physician
  • El Paso, TX
  • NPI 1962896340

  TX

  Medicare reassignment

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1497920078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10720 N LOOP DR",
            "address_2": "STE A-6",
            "city": "SOCORRO",
            "state": "TX",
            "postal_code": "799274409",
            "telephone_number": "915-858-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10720 N LOOP DR",
            "address_2": "STE A-6",
            "city": "SOCORRO",
            "state": "TX",
            "postal_code": "799274409",
            "telephone_number": "915-858-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTTEMAN",
        "first_name": "HENRY",
        "middle_name": "RUSSELL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-24",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eddie Hernandez
• Genesis Hernandez
• Denise Andrea Herrera
• Marianna Herrera, RN
• Rigoberto Herrera
• Iglesias Family Medicine PA
• Michelle Iglesias, M.D.
• Martins Oriarehu Monday Ituah
• Bonita Faith Jaime, RN
• Jr Dental Group, PLLC

• All providers in Socorro, TX
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.