Individual provider Active NPI

Manuel Jose Hernandez, PHYSICAL THERAPIST

  • Physical Therapist
  • El Paso, TX
National Provider Identifier
1750510806
Registry record updated Jul 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1189421 Issued in TX
Practice address
2280 Trawood Dr
El Paso, TX 79935-3020
Phone
(915) 595-3535
Fax
(915) 595-3922
NPI assigned
Jul 10, 2009
Last updated
Jul 10, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1189421 TX Primary

Addresses

Primary practice location

2280 Trawood Dr
El Paso, TX 79935-3020

Mailing address

2280 Trawood Dr
El Paso, TX 79935-3020
Phone (915) 595-3535

Other identifiers 1

IdentifierTypeStateIssuer
1189421OtherTXLICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090810000439 TX Practitioner - Physical Therapist in Private Practice 8820142813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Border Therapy Services LLCGroup PAC ID 1355421181, 36 clinicians

Practice addresses (Care Compare)

12801 B Edgemere Blvd
Suite 102
El Paso, TX 79938-9652
Phone (915) 493-6795

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Border Therapy Services LLC Physical Therapist CurrentSince Jul 16, 2009 Accepting new patients

Locations

12801 Edgemere Blvd
#102
El Paso, TX 79938
Phone (915) 493-6795

12801 Edgemere Blvd
Ste 102B
El Paso, TX 79938
Phone (915) 493-6795

2280 Trawood Dr
El Paso, TX 79935
Phone (915) 493-6794

3215 Gateway Blvd W
Ste 201
El Paso, TX 79903
Phone (915) 493-6799

4242 Hondo Pass Dr
Ste 110
El Paso, TX 79904
Phone (915) 751-0595

836 E Redd Rd
#B
El Paso, TX 79912
Phone (915) 845-4060

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247184000000",
    "number": "1750510806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2280 TRAWOOD DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799353020",
            "telephone_number": "915-595-3535",
            "fax_number": "915-595-3922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 TRAWOOD DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799353020",
            "telephone_number": "915-595-3535",
            "fax_number": "915-595-3922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MANUEL",
        "middle_name": "JOSE",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-10",
        "last_updated": "2009-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1189421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "1189421",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.