Individual provider Active NPI

Jose Alberto Ruiz, FNP

  • Family Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1629669023
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1022594 Issued in TX
Practice address
840 E Redd Rd BLDG 2
El Paso, TX 79912-7265
Phone
(915) 845-2220
NPI assigned
Jan 28, 2021
Last updated
Jan 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1022594 TX Primary

Addresses

Primary practice location

840 E Redd Rd BLDG 2
El Paso, TX 79912-7265

Mailing address

2820 Granite Rock Dr
El Paso, TX 79938-2731

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
I20210930001037 TX Practitioner - Nurse Practitioner 6305243536 Reassigns benefits to 1 organization
Practice locations: El Paso, TX

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Primary Care Clinic LLCGroup PAC ID 4385075993, 2 clinicians

Practice addresses (Care Compare)

11351 James Watt Dr
Suite C 300
El Paso, TX 79936-6627
Phone (915) 320-7707

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1022594TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Primary Care Clinic PLLC Family CurrentSince Jun 18, 2021 Accepting new patients
Premier Workcare PLLC CurrentSince Jul 30, 2026 Accepting new patients
El Paso Wellness and Healthcare Center P.a. CurrentSince Jan 31, 2021 Accepting new patients

Locations

1014 N Stanton St
El Paso, TX 79902
Phone (915) 230-2000

11351 James Watt Dr
Ste 300
El Paso, TX 79936

121 Paragon Ln
Ste B
El Paso, TX 79912
Phone (915) 545-2525

1387 George Dieter Dr
Bldg D
El Paso, TX 79936
Phone (915) 532-3721

1387 George Dieter Dr
Ste D103
El Paso, TX 79936
Phone (915) 544-0026

3641 Mattox St
El Paso, TX 79925
Phone (915) 532-6280

840 E Redd Rd
Bldg 2
El Paso, TX 79912
Phone (915) 845-2220

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1629669023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 GRANITE ROCK DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799382731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 E REDD RD BLDG 2",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799127265",
            "telephone_number": "915-845-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "JOSE",
        "middle_name": "ALBERTO",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1022594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.