Individual provider Active NPI

Sandra Rebekah Flores, PNP- AC

  • Pediatric Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1629437447
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP130105 Issued in TX
Practice address
1600 Medical Center Dr Ste 101
El Paso, TX 79902-5008
Phone
(915) 319-9718
Fax
(915) 544-6740
NPI assigned
Feb 22, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP130105 TX Primary

Addresses

Primary practice location

1600 Medical Center Dr Ste 101
El Paso, TX 79902-5008

Mailing address

1600 Medical Center Dr Ste 101
El Paso, TX 79902-5008
Phone (915) 319-9718

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160725002863 TX Practitioner - Nurse Practitioner 1456644798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Ear Nose and Throat Consultants PAGroup PAC ID 9032151717, 6 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP130105TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Ear Nose & Throat Consultants PA CurrentSince Jun 21, 2016 Accepting new patients

Locations

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

Organizations & group practices 1

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": "1456099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1629437447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DR STE 101",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799025008",
            "telephone_number": "915-319-9718",
            "fax_number": "915-566-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MEDICAL CENTER DR STE 101",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799025008",
            "telephone_number": "915-319-9718",
            "fax_number": "915-544-6740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "SANDRA",
        "middle_name": "REBEKAH",
        "credential": "PNP- AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-22",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP130105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.