NPIMap

Individual provider Active NPI

Dwayne Eldrich Friday

  • Internal Medicine Physician
  • El Paso, TX
National Provider Identifier
1619101557
Registry record updated Nov 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P3150 Issued in TX
Practice address
811 Chelsea St Ste a
El Paso, TX 79903-4925
Phone
(915) 259-1390
NPI assigned
May 6, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X P3150 TX Primary

Addresses

Primary practice location

811 Chelsea St Ste a
El Paso, TX 79903-4925

Mailing address

811 Chelsea St
Ste B
El Paso, TX 79903-4925
Phone (915) 259-1390

Other identifiers 1

IdentifierTypeStateIssuer
298202701MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120619000571 TX Practitioner - Internal Medicine 9739343989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dwayne Friday MD PLLCGroup PAC ID 6002180171, 5 clinicians

Practice addresses (Care Compare)

811 Chelsea St
El Paso, TX 79903-4925
Phone (915) 259-1390

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Dwayne Friday, M.D., PLLC Internal Medicine CurrentSince Jun 8, 2017 Accepting new patients
El Paso Healthcare System LTD Past Accepting new patients

Locations

811 Chelsea St
#A
El Paso, TX 79903
Phone (915) 259-1390

113 E Redd Rd
El Paso, TX 79932
Phone (915) 259-1390

811 Chelsea St
#B
El Paso, TX 79903
Phone (915) 201-0199

Organizations & group practices 2

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1619101557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 CHELSEA ST",
            "address_2": "STE B",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799034925",
            "telephone_number": "915-259-1390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 CHELSEA ST STE A",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799034925",
            "telephone_number": "915-259-1390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIDAY",
        "first_name": "DWAYNE",
        "middle_name": "ELDRICH",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-06",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P3150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "298202701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.