Individual provider Active NPI

Moises Plasencia, MD

  • Family Medicine Physician
  • Lubbock, TX
National Provider Identifier
1699209494
Registry record updated Aug 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R9665 Issued in TX
Practice address
1910 Quaker Ave Ste 101
Lubbock, TX 79407-2433
Phone
(806) 725-4440
Fax
(806) 725-4441
NPI assigned
Apr 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X BP10060995 TX
Family Medicine Physician 207Q00000X R9665 TX Primary

Addresses

Primary practice location

1910 Quaker Ave Ste 101
Lubbock, TX 79407-2433

Mailing address

2215 Nashville Ave
Lubbock, TX 79410-1105
Phone (806) 725-5844

Other practice location 1

11937 US Highway 271
Tyler, TX 75708-3154
Phone (903) 877-7777

Other identifiers 2

IdentifierTypeStateIssuer
8MU705OtherTXBCBS
1E2664OtherTXMEDICARE

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
I20200708001261 TX Practitioner - Family Practice 8729359476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas Tech University Health Science Center School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical GroupGroup PAC ID 6901889393, 228 clinicians

Practice addresses (Care Compare)

2215 Nashville Ave
Lubbock, TX 79410-1105
Phone (806) 725-5844

Hospital & facility affiliations

  • Covenant Medical Center Hospital, Lubbock, TX, CCN 450040

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group Family Medicine CurrentSince Aug 1, 2020 Accepting new patients
Covenant Medical Group Family Medicine CurrentSince Aug 1, 2020 Accepting new patients

Locations

1910 Quaker Ave
Ste 101
Lubbock, TX 79407
Phone (806) 725-4440

2215 Nashville Ave
Lubbock, TX 79410
Phone (806) 725-5228

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 and National Provider Directory roles.

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": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596412800000",
    "number": "1699209494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 NASHVILLE AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101105",
            "telephone_number": "806-725-5844",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 QUAKER AVE STE 101",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794072433",
            "telephone_number": "806-725-4440",
            "fax_number": "806-725-4441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11937 US Highway 271",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757083154",
            "country_code": "US",
            "telephone_number": "903-877-7777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLASENCIA",
        "first_name": "MOISES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-18",
        "last_updated": "2020-08-03",
        "certification_date": "2020-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10060995",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R9665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8MU705",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1E2664",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.