Individual provider Active NPI

Luis R. Venegas, DPM PA

  • Foot & Ankle Surgery Podiatrist
  • Brownsville, TX
National Provider Identifier
1780776963
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO1452 Issued in TX
Practice address
40 Marsella Blvd
Brownsville, TX 78521-3579
Phone
(956) 574-9733
Fax
(956) 574-9730
NPI assigned
Sep 28, 2006
Last updated
Mar 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO1452 TX Primary

Addresses

Primary practice location

40 Marsella Blvd
Brownsville, TX 78521-3579

Mailing address

5493 Rustic Manor
Brownsville, TX 78526-3920
Phone (956) 574-9733

Other identifiers 5

IdentifierTypeStateIssuer
018590201MedicaidTX
00457EOtherTXBLUE CROSS AND BLUE SHIELD OF TEXAS
7317044OtherTXAETNA
480032167OtherTXMEDICARE RAILROAD
7571063OtherTXCIGNA

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040810000510 TX Practitioner - Podiatry 4385616416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

40 Marsella Blvd
Brownsville, TX 78521-7936
Phone (956) 574-9733

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue146
Removal of nail tissue1503
Removal or shaving of skin growth127
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1452TXMDClinical Social Worker
PO1452TXMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Brownsville Podiatric Wound Care and Surgery Foot & Ankle Surgery CurrentSince May 25, 2005 Accepting new patients

Locations

3104 International Blvd
#C
Brownsville, TX 78521
Phone (956) 504-3707

40 Marsella Blvd
Brownsville, TX 78521
Phone (956) 504-1469

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.

Hospital & facility affiliations 4

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1780776963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5493 RUSTIC MANOR",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785263920",
            "telephone_number": "956-574-9733",
            "fax_number": "956-574-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 MARSELLA BLVD",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785213579",
            "telephone_number": "956-574-9733",
            "fax_number": "956-574-9730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENEGAS",
        "first_name": "LUIS",
        "middle_name": "R.",
        "credential": "DPM PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2022-03-07",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "PO1452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018590201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD OF TEXAS",
            "identifier": "00457E",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7317044",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "480032167",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7571063",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, TX

Sources for this page

Verify at the official NPI Registry.