Individual provider Active NPI

Ediberto Soto-Cora, M.D.

  • Cardiovascular Disease Physician
  • El Paso, TX
National Provider Identifier
1588679443
Registry record updated Jan 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
J0679 Issued in TX
Practice address
1139 Caper Rd
El Paso, TX 79925-7739
Phone
(915) 591-7495
Fax
(915) 592-5623
NPI assigned
Jul 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X J0679 TX Primary

Addresses

Primary practice location

1139 Caper Rd
El Paso, TX 79925-7739

Mailing address

1139 Caper Rd
El Paso, TX 79925-7739
Phone (915) 591-7495

Other practice location 1

1139 Caper Rd
El Paso, TX 79925-7739
Phone (915) 591-7495

Other identifiers 2

IdentifierTypeStateIssuer
123136704MedicaidTX
00J12GOtherTXBCBS

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081201000642 TX Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 9638230253 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
J0679TXMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BHS Physicians Network, Inc CurrentSince Feb 1, 2018 Accepting new patients
BHS Physicians Network, Inc CurrentSince Feb 1, 2018 Accepting new patients
Cardiac Cath Lab of Tyler LP PastSince Jul 13, 2009 Accepting new patients
BHS Specialty Network Inc Cardiovascular Disease Past Accepting new patients
Youngs Professional Services LLC Past Accepting new patients
Ediberto Soto-Cora, M.D., P.a. Cardiovascular Disease PastSince Mar 1, 1994 Accepting new patients

Locations

1139 Caper Rd
El Paso, TX 79925
Phone (915) 308-9467

1625 Medical Center Dr
El Paso, TX 79902
Phone (915) 577-7746

2001 N Oregon St
#M
El Paso, TX 79902
Phone (915) 577-6011

2001 N Oregon St
El Paso, TX 79902
Phone (915) 577-6011

3903 Wiseman Blvd
Ste 100
San Antonio, TX 78251
Phone (210) 681-0126

3903 Wiseman Blvd
San Antonio, TX 78251
Phone (210) 681-0126

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517184000000",
    "number": "1588679443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1139 CAPER RD",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799257739",
            "telephone_number": "915-591-7495",
            "fax_number": "915-592-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1139 CAPER RD",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799257739",
            "telephone_number": "915-591-7495",
            "fax_number": "915-592-5623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1139 Caper Rd",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799257739",
            "country_code": "US",
            "telephone_number": "915-591-7495",
            "fax_number": "915-592-5623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOTO-CORA",
        "first_name": "EDIBERTO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2018-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "J0679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123136704",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00J12G",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.