Individual provider Active NPI

Graciela Vasquez, FNP-C

  • Family Nurse Practitioner
  • Linthicum, MD
National Provider Identifier
1649957820
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1126456 Issued in TX
Practice address
785 Elkridge Landing Rd Ste 300
Linthicum, MD 21090-2958
Phone
(443) 275-9800
NPI assigned
Jun 29, 2023
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 74758 NM
Family Nurse Practitioner 363LF0000X 1126456 TX Primary

Addresses

Primary practice location

785 Elkridge Landing Rd Ste 300
Linthicum, MD 21090-2958

Mailing address

2605 Bert Yancey Dr
El Paso, TX 79936-2705
Phone (915) 867-1967

Other practice location 1

2121 Wyoming Ave
El Paso, TX 79903-3508
Phone (915) 249-4470

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
I20230929002994 TX Practitioner - Nurse Practitioner 3678927225 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palliative Coalition PLLCGroup PAC ID 8325482078, 5 clinicians

Practice addresses (Care Compare)

2121 Wyoming Ave
El Paso, TX 79903-3508
Phone (915) 249-4470

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
74758NMMDFamily Nurse Practitioner
1126456TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Palliative Coalition PLLC CurrentSince Jan 9, 2024 Accepting new patients
Medical Services of the Border PA CurrentSince Sep 15, 2023 Accepting new patients

Locations

1031 N Zaragoza Rd
El Paso, TX 79907
Phone (915) 317-7699

2121 Wyoming Ave
El Paso, TX 79903
Phone (915) 249-4470

4849 N Mesa St
Ste 201
El Paso, TX 79912

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EAFIBD

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 4

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": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1649957820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 BERT YANCEY DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799362705",
            "telephone_number": "915-867-1967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 ELKRIDGE LANDING RD STE 300",
            "city": "LINTHICUM",
            "state": "MD",
            "postal_code": "210902958",
            "telephone_number": "443-275-9800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2121 Wyoming Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799033508",
            "country_code": "US",
            "telephone_number": "915-249-4470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "GRACIELA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-29",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "74758",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1126456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Linthicum, MD

Sources for this page

Verify at the official NPI Registry.