Active NPI
Denise Rebecca Cubillos, LSA
- Surgical Physician Assistant
- El Paso, TX
National Provider Identifier
1528105699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- SA00116
- Practice address
- 3007 Killarney St
El Paso, TX 79925-4170 - Phone
- (915) 203-7894
- NPI assigned
- Jan 30, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | SA00116 | TX | |
| Surgical Physician Assistant | 363AS0400X | SA00116 | TX | Primary |
Addresses
Primary practice location
3007 Killarney St
El Paso, TX 79925-4170
Mailing address
8900 Viscount
Pmb213
El Paso, TX 79925
Phone (915) 203-7894
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0083JR | Other | TX | BCBS |
| 142239400 | Other | TX | US DEPT OF LABOR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA00116 | TX | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604534400000",
"number": "1528105699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8900 VISCOUNT",
"address_2": "PMB213",
"city": "EL PASO",
"state": "TX",
"postal_code": "79925",
"telephone_number": "915-203-7894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3007 KILLARNEY ST",
"city": "EL PASO",
"state": "TX",
"postal_code": "799254170",
"telephone_number": "915-203-7894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUBILLOS",
"first_name": "DENISE",
"middle_name": "REBECCA",
"credential": "LSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-30",
"last_updated": "2020-11-05",
"certification_date": "2020-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "TX",
"license": "SA00116",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "TX",
"license": "SA00116",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0083JR",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US DEPT OF LABOR",
"identifier": "142239400",
"state": "TX"
}
],
"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 Nov 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.