Individual provider Active NPI

Vanessa Stephanie Olivares, AU.D

  • Audiologist
  • El Paso, TX
National Provider Identifier
1609542026
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
81604 Issued in TX
Practice address
9830 Gateway Blvd N
El Paso, TX 79924-4410
Phone
(915) 215-6891
Fax
(915) 215-6892
NPI assigned
Aug 17, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 81604 TX
Audiologist 231H00000X 81604 TX Primary

Addresses

Primary practice location

9830 Gateway Blvd N
El Paso, TX 79924-4410

Mailing address

5130 Gateway Blvd E
El Paso, TX 79905-1608
Phone (915) 215-4480

Other practice location 1

1600 Medical Center Dr Ste 101
El Paso, TX 79902-5008
Phone (915) 544-1350

Other practice location 2

4801 Alberta Ave
El Paso, TX 79905-2707
Phone (915) 215-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220728002772 CO Practitioner - Qualified Audiologist 8820475999 Reassigns benefits to 1 organization
I20230817003415 TX Practitioner - Qualified Audiologist 8820475999 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

9830 Gateway Blvd N
El Paso, TX 79924-4410
Phone (915) 215-6891

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
81604TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center El Paso CurrentSince Feb 1, 2025 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Feb 1, 2025 Accepting new patients
Southwest Ear Nose & Throat Consultants PA CurrentSince Jun 12, 2023 Accepting new patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients
Denver Health and Hospital Authority CurrentSince Apr 16, 2022 Accepting new patients
Denver Health and Hospital Authority CurrentSince Apr 16, 2022 Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

9830 Gateway Blvd N
El Paso, TX 79924
Phone (915) 215-6891

4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200

1600 Medical Center Dr
Ste 101
El Paso, TX 79902
Phone (915) 544-1350

Organizations & group practices 6

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": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1609542026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 GATEWAY BLVD E",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799051608",
            "telephone_number": "915-215-4480",
            "fax_number": "915-215-5386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9830 GATEWAY BLVD N",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799244410",
            "telephone_number": "915-215-6891",
            "fax_number": "915-215-6892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Medical Center Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799025008",
            "country_code": "US",
            "telephone_number": "915-544-1350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4801 Alberta Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052707",
            "country_code": "US",
            "telephone_number": "915-215-5300",
            "fax_number": "915-215-8605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVARES",
        "first_name": "VANESSA",
        "middle_name": "STEPHANIE",
        "credential": "AU.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-17",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "TX",
            "license": "81604",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "81604",
            "primary": true
        }
    ],
    "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 Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.