Individual provider Active NPI

Derrick Delgado, PTA

  • Physical Therapy Clinic/Center
  • Santa Teresa, NM
National Provider Identifier
1639522964
Registry record updated Oct 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
PTA1723 Issued in NM
Practice address
5312 Rio Bravo Dr Ste 7
Santa Teresa, NM 88008-9210
Phone
(575) 201-3726
NPI assigned
Jul 21, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA1723 NM
Physical Therapy Clinic/Center 261QP2000X PTA1723 NM Primary

Addresses

Primary practice location

5312 Rio Bravo Dr Ste 7
Santa Teresa, NM 88008-9210

Mailing address

1229 Coyote LN
El Paso, TX 79912-7490
Phone (915) 252-0596

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTA1723NMMDPhysical Therapy Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Altomar Medical Equipment Company, LLC PastSince Sep 1, 2020 Accepting new patients

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": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760832000000",
    "number": "1639522964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 COYOTE LN",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799127490",
            "telephone_number": "915-252-0596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5312 RIO BRAVO DR STE 7",
            "city": "SANTA TERESA",
            "state": "NM",
            "postal_code": "880089210",
            "telephone_number": "575-201-3726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELGADO",
        "first_name": "DERRICK",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-21",
        "last_updated": "2025-10-19",
        "certification_date": "2025-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NM",
            "license": "PTA1723",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NM",
            "license": "PTA1723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Teresa, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.