Dora Maria Carcoba, ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

596064 Issued in TX

Practice address

101 Rim Rd
Suite 300
El Paso, TX 79902-3667

Phone

(915) 532-4542

Fax

(915) 532-1163

NPI assigned

Mar 19, 2009

Last updated

Aug 6, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

VMD Primary Providers of West Texas PLLCGroup PAC ID 7810327384, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dora.carcoba.1@13711.direct.athenahealth.com

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.

• VMD Primary Providers of West Texas PLLC

  • Family Medicine Physician
  • El Paso, TX
  • NPI 1619503026
  Medicare reassignment Care Compare group NPD
• BHS Physicians Network, Inc

  dba Orthopedic Performance Institute

  • Durable Medical Equipment & Medical Supplies
  • Boerne, TX
  • NPI 1730079286
  NPD (past)

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

{
    "created_epoch": "1237420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344211200000",
    "number": "1689815797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 RIM RD",
            "address_2": "SUITE 300",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799023667",
            "telephone_number": "915-532-4542",
            "fax_number": "915-532-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 RIM RD",
            "address_2": "SUITE 300",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799023667",
            "telephone_number": "915-532-4542",
            "fax_number": "915-532-1163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARCOBA",
        "first_name": "DORA",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "ACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-19",
        "last_updated": "2012-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "596064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205285401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gynna Carbajal Bustos, FNP-C
• Crystal M Carbajal, FNP
• Jesse Carbajal, PTA
• Jessica Victoria Carbajal, LVN
• Benjamin Carcamo, M.D.
• Joshua Michael Cardenas, MD
• Magdaleno Rafael Cardenas Jr., MD
• Maria Guadalupe Cardenas, M.D.
• Stephanie Marissa Cardenas, NP
• Cardiac Cath Lab of El Paso LP (El Paso Cardiac and Endovascular Center)

• Acute Care Nurse Practitioner in El Paso, TX
• Providers in El Paso, TX by specialty
• Acute Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.