Organization Active NPI

El Paso Diabetes Association, Inc.

  • Voluntary or Charitable Agency
  • El Paso, TX
National Provider Identifier
1548580491
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Voluntary or Charitable AgencyTaxonomy code 251V00000X
Legal business name
EL PASO DIABETES ASSOCIATION, INC.
Practice address
3641 Mattox St
El Paso, TX 79925-1307
Phone
(915) 532-6280
Fax
(915) 598-3732
NPI assigned
Jun 2, 2010
Last updated
Aug 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Authorized official

Name
Ms. Sandra Gonzalez
Title
Executive Director
Phone
(915) 532-6280

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Voluntary or Charitable Agency 251V00000X TX Primary
Metabolic Nutrition Registered Dietitian 133VN1006X NU

Addresses

Primary practice location

3641 Mattox St
El Paso, TX 79925-1307

Mailing address

3641 Mattox St
El Paso, TX 79925-1307
Phone (915) 532-6280

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140711002025 TX Part B Supplier - Clinic/Group Practice 8628293347 Receives reassigned benefits from 1 practitioner
Practice locations: El Paso, TX

National Provider Directory

National Provider Directory

Locations

3641 Mattox St
El Paso, TX 79925
Phone (915) 532-6280

Practitioners & affiliated clinicians

Practitioners 2

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": "1275436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691366400000",
    "number": "1548580491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3641 MATTOX ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799251307",
            "telephone_number": "915-532-6280",
            "fax_number": "915-598-3732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3641 MATTOX ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799251307",
            "telephone_number": "915-532-6280",
            "fax_number": "915-598-3732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL PASO DIABETES ASSOCIATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-02",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "915-532-6280",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Aug 7, 2023; 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.