Individual provider Active NPI

Hector Manuel Perez

  • Psychiatric/Mental Health Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1588355697
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
73456 Issued in NM
Practice address
1072 Leticia River Place
El Paso, TX 79932
Phone
(818) 804-0453
NPI assigned
May 18, 2023
Last updated
Jun 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 73456 NM Primary

Addresses

Primary practice location

1072 Leticia River Place
El Paso, TX 79932

Mailing address

1072 Leticia Rivera Place
El Paso, TX 79932
Phone (818) 804-0453

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20240401002674 NM Practitioner - Nurse Practitioner 1658719307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PHC-Las Cruces IncGroup PAC ID 4486635802, 22 clinicians

Practice addresses (Care Compare)

2450 S Telshor Blvd
Las Cruces, NM 88011-5069
Phone (575) 556-6550

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
73456NMMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PHC-Las Cruces Inc Single Specialty Current Accepting new patients
PHC Las Cruces Inc. Single Specialty CurrentSince Feb 19, 2024 Accepting new patients
PHC Las Cruces Inc CurrentSince Feb 19, 2024 Accepting new patients
PHC-Las Cruces Inc Past Accepting new patients

Locations

2450 S Telshor Blvd
Las Cruces, NM 88011
Phone (505) 522-8641

2450 S Telshor Blvd
Ste B
Las Cruces, NM 88011
Phone (575) 556-5800

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1588355697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1072 LETICIA RIVERA PLACE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79932",
            "telephone_number": "818-804-0453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1072 LETICIA RIVER PLACE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "79932",
            "telephone_number": "818-804-0453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "HECTOR",
        "middle_name": "MANUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-18",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "73456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.