Individual provider Active NPI

Benjamin Trujillo

  • Family Nurse Practitioner
  • Lubbock, TX
National Provider Identifier
1699358200
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP143973 Issued in TX
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

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240131001859 TX Practitioner - Nurse Practitioner 3476906991 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP143973TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa of Texas PLLC CurrentSince Oct 20, 2025 Accepting new patients
Harmonycares Complete Health Services, PLLC Family Medicine CurrentSince Dec 7, 2025 Accepting new patients
Vpa of Texas PLLC Family Medicine CurrentSince Oct 20, 2025 Accepting new patients

Locations

4545 Fuller Dr
Ste 325
Irving, TX 75038
Phone (972) 870-5511

Interoperability endpoints

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.