Active NPI
Raquel Vallejo-Moore, PA-C
- Physician Assistant
- El Paso, TX
National Provider Identifier
1790010650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA02871
- Practice address
- 2325 Pershing Dr
El Paso, Texas 79903
El Paso, TX 79903-3608 - Phone
- (915) 590-5600
- Fax
- (915) 590-7367
- NPI assigned
- Oct 12, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA02871 | TX | Primary |
Addresses
Primary practice location
2325 Pershing Dr
El Paso, Texas 79903
El Paso, TX 79903-3608
Mailing address
2325 Pershing Dr
El Paso, Texas 79903
El Paso, TX 79903-3608
Phone (915) 590-5600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA02871 | TX | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comprehensive Healthcare | Current | Accepting new patients |
Locations
402 S 4th Ave
Yakima, WA 98902
Phone (509) 575-3874
Organizations & group practices 4
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.
-
- Psychiatry Physician
- San Antonio, TX
- NPI 1518548262
-
- Psychiatry Physician
- El Paso, TX
- NPI 1053578021
-
- Community/Behavioral Health Agency
- Yakima, WA
- NPI 1073527453
-
- Methadone Clinic
- Yakima, WA
- NPI 1588871693
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255305600000",
"number": "1790010650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2325 PERSHING DR",
"address_2": "EL PASO, TEXAS 79903",
"city": "EL PASO",
"state": "TX",
"postal_code": "799033608",
"telephone_number": "915-590-5600",
"fax_number": "915-590-7367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2325 PERSHING DR",
"address_2": "EL PASO, TEXAS 79903",
"city": "EL PASO",
"state": "TX",
"postal_code": "799033608",
"telephone_number": "915-590-5600",
"fax_number": "915-590-7367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALLEJO-MOORE",
"first_name": "RAQUEL",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-12",
"last_updated": "2009-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA02871",
"primary": true
}
],
"identifiers": [],
"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 Oct 12, 2009; 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.