NPIMap

Organization Active NPI

Texas Tech University Health Sciences Center El Paso

  • Neurology Physician
  • El Paso, TX
National Provider Identifier
1548389554
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER EL PASO
Practice address
4615 Alameda Ave
El Paso, TX 79905-2702
Phone
(915) 545-6830
Fax
(915) 545-9799
NPI assigned
Mar 29, 2007
Last updated
Apr 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Authorized official

Name
Sue Fuciarelli
Title
Vice President for Finance and Admi
Phone
(915) 215-4300

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X
Pediatric Neurodevelopmental Disabilities PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0008X
Neurocritical Care PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084A2900X
Diagnostic Neuroimaging (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084D0003X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary
Neurology with Special Qualifications in Child Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0402X
Vascular Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084V0102X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X

Addresses

Primary practice location

4615 Alameda Ave
El Paso, TX 79905-2702

Mailing address

PO Box 9520
El Paso, TX 79995-9520
Phone (915) 545-6664

Other practice location 1

2000 B Transmountain Road
El Paso, TX 79911
Phone (915) 215-8408

Other practice location 2

1891 Broadway #3
Van Horn, TX 79830
Phone (432) 283-9133

Other practice location 3

1605 N Fort Davis Highway
Alpine, TX 79830
Phone (432) 837-4555

Other practice location 4

1501 N Erma St
Presidio, TX 79845
Phone (432) 229-3030

Other identifiers 2

IdentifierTypeStateIssuer
084595001MedicaidTX
CC8142OtherTXRAILROAD MEDICARE GROUP #

Other names 1

  • Texas Tech UHSC Neurology Dept. Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031216000806 TX Part B Supplier - Clinic/Group Practice 7517864754 Receives reassigned benefits from 864 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: El Paso, TX; Alpine, TX

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Texas Tech University El Paso27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Practitioners & affiliated clinicians

Practitioners 125

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.

View all 125

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650240000000",
    "number": "1548389554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9520",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799959520",
            "telephone_number": "915-545-6664",
            "fax_number": "915-545-9799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 ALAMEDA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052702",
            "telephone_number": "915-545-6830",
            "fax_number": "915-545-9799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 B Transmountain Road",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "79911",
            "country_code": "US",
            "telephone_number": "915-215-8408",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1891 Broadway #3",
            "address_purpose": "LOCATION",
            "city": "Van Horn",
            "state": "TX",
            "postal_code": "79830",
            "country_code": "US",
            "telephone_number": "432-283-9133",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1605 N Fort Davis Highway",
            "address_purpose": "LOCATION",
            "city": "Alpine",
            "state": "TX",
            "postal_code": "79830",
            "country_code": "US",
            "telephone_number": "432-837-4555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1501 N Erma St",
            "address_purpose": "LOCATION",
            "city": "Presidio",
            "state": "TX",
            "postal_code": "79845",
            "country_code": "US",
            "telephone_number": "432-229-3030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER EL PASO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A",
        "authorized_official_last_name": "FUCIARELLI",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "VICE PRESIDENT FOR FINANCE AND ADMI",
        "authorized_official_telephone_number": "915-215-4300"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0008X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084A2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084D0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Diagnostic Neuroimaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084595001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP #",
            "identifier": "CC8142",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Texas Tech UHSC Neurology Dept.",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Texas Tech UHSC Neurology Dept.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Apr 18, 2022; 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.