Individual provider Active NPI

Vincent Alexander Jr., AGACNP

  • Acute Care Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1639824485
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1061488 Issued in TX
Practice address
14957 Jerry Armstrong CT
El Paso, TX 79938-1039
Phone
(915) 630-4071
NPI assigned
Feb 18, 2022
Last updated
Sep 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1061488 TX Primary
Critical Care Medicine Nurse Practitioner 363LC0200X 1061488 TX
Gerontology Nurse Practitioner 363LG0600X 1061488 TX

Addresses

Primary practice location

14957 Jerry Armstrong CT
El Paso, TX 79938-1039

Mailing address

14957 Jerry Armstrong CT
El Paso, TX 79938-1039
Phone (915) 630-4071

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
I20220611000327 TX Practitioner - Nurse Practitioner 7416335948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fahad Omar MD PAGroup PAC ID 6305120031, 12 clinicians
Revive Global PLLCGroup PAC ID 5395273429, 9 clinicians

Practice addresses (Care Compare)

1512 N Zaragoza Rd
BLDG B
El Paso, TX 79936-8903
Phone (915) 213-0900

5539 N Mesa St
El Paso, TX 79912-5422
Phone (915) 213-0900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
74.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1061488TXMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fahad Omar MD PA CurrentSince Jun 1, 2022 Accepting new patients
Revive Global PLLC CurrentSince Feb 15, 2025 Accepting new patients

Locations

1512 N Zaragoza Rd
Ste B
El Paso, TX 79936
Phone (915) 249-3900

5539 N Mesa St
El Paso, TX 79912

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1645142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1639824485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14957 JERRY ARMSTRONG CT",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799381039",
            "telephone_number": "915-630-4071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14957 JERRY ARMSTRONG CT",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799381039",
            "telephone_number": "915-630-4071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEXANDER",
        "first_name": "VINCENT",
        "name_suffix": "Jr.",
        "credential": "AGACNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-18",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1061488",
            "primary": true
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "TX",
            "license": "1061488",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1061488",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.