Individual provider Active NPI

Manouchehr Refaeian, M.D.

  • Pain Medicine Physician
  • El Paso, TX
National Provider Identifier
1689632945
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
J6684 Issued in TX
Practice address
10412 Vista del Sol Dr Ste 1B
El Paso, TX 79925-7937
Phone
(915) 233-4026
Fax
(915) 233-4026
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X J6684 TX Primary

Addresses

Primary practice location

10412 Vista del Sol Dr Ste 1B
El Paso, TX 79925-7937

Mailing address

10412 Vista del Sol Dr Ste 1B
El Paso, TX 79925-7937
Phone (915) 233-4026

Other identifiers 3

IdentifierTypeStateIssuer
031059101MedicaidTX
5073416OtherAETNA
8A8950OtherTXBLUE CROSS BLUE SHIELD

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051216000536 TX Practitioner - Physical Medicine and RehabilitationPractitioner - Pain Management 7416975123

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Pain Management
Education
Texas Tech University Health Science Center School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10412 Vista del Sol
Suite 1B
El Paso, TX 79925-7937

10412 Vista del Sol Dr
1B
El Paso, TX 79925-7937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
J6684TXMDPain Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1689632945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10412 VISTA DEL SOL DR STE 1B",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799257937",
            "telephone_number": "915-233-4026",
            "fax_number": "915-233-4026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10412 VISTA DEL SOL DR STE 1B",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799257937",
            "telephone_number": "915-233-4026",
            "fax_number": "915-233-4026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REFAEIAN",
        "first_name": "MANOUCHEHR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "TX",
            "license": "J6684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031059101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5073416",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8A8950",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.