Active NPI
Benjamin Trujillo
- Family Nurse Practitioner
- Lubbock, TX
National Provider Identifier
1699358200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP143973
- Practice address
- 3702 21St St
Lubbock, TX 79410-1299 - Phone
- (806) 795-2751
- NPI assigned
- May 2, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | AP143973 | TX | |
| Family Nurse Practitioner | 363LF0000X | AP143973 | TX | Primary |
Addresses
Primary practice location
3702 21St St
Lubbock, TX 79410-1299
Mailing address
5510 79TH St
Lubbock, TX 79424-2606
Phone (806) 778-7830
Other practice location 1
5510 79th St
Lubbock, TX 79424-2606
Phone (806) 778-7830
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP143973 | TX | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vpa of Texas PLLC | Current | Accepting new patients | |
| Harmonycares Complete Health Services, PLLC | Family Medicine | Current | Accepting new patients |
| Vpa of Texas PLLC | Family Medicine | Current | Accepting new patients |
Locations
4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511
Interoperability endpoints
- btrujillo1362434@oc.providencedirect.org
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Irving, TX
- NPI 1679510499
-
- Clinical Social Worker
- San Antonio, TX
- NPI 1578175865
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706745600000",
"number": "1699358200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5510 79TH ST",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794242606",
"telephone_number": "806-778-7830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3702 21ST ST",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794101299",
"telephone_number": "806-795-2751"
}
],
"practiceLocations": [
{
"address_1": "5510 79th St",
"address_purpose": "LOCATION",
"city": "Lubbock",
"state": "TX",
"postal_code": "794242606",
"country_code": "US",
"telephone_number": "806-778-7830",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TRUJILLO",
"first_name": "BENJAMIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-02",
"last_updated": "2024-02-01",
"certification_date": "2024-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "AP143973",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "AP143973",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.