Individual provider Active NPI

Andrew Herrera, AGACNP-BC

  • Acute Care Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1790392371
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1011146 Issued in TX
Practice address
1512 N Zaragoza Rd
El Paso, TX 79936-8902
Phone
(915) 213-0900
Fax
(915) 271-4145
NPI assigned
Sep 28, 2020
Last updated
Sep 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1011146 TX Primary
Gerontology Nurse Practitioner 363LG0600X 1011146 TX

Addresses

Primary practice location

1512 N Zaragoza Rd
El Paso, TX 79936-8902

Mailing address

8105 Hickory LN
El Paso, TX 79915-4621
Phone (915) 667-6208

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
I20210301001363 TX Practitioner - Nurse Practitioner 3173939089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fahad Omar MD PAGroup PAC ID 6305120031, 12 clinicians
Revive Global PLLCGroup PAC ID 5395273429, 9 clinicians

Practice addresses (Care Compare)

1512 N Zaragoza Rd
BLDG B
El Paso, TX 79936-8903
Phone (915) 213-0900

5539 N Mesa St
El Paso, TX 79912-5422
Phone (915) 213-0900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
74.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1011146TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fahad Omar MD PA CurrentSince Dec 1, 2020 Accepting new patients
Revive Global PLLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

1512 N Zaragoza Rd
El Paso, TX 79936
Phone (915) 855-0601

1512 N Zaragoza Rd
Ste B
El Paso, TX 79936
Phone (915) 249-3900

5539 N Mesa St
El Paso, TX 79912

Organizations & group practices 2

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 3

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": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1790392371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8105 HICKORY LN",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799154621",
            "telephone_number": "915-667-6208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 N ZARAGOZA RD",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799368902",
            "telephone_number": "915-213-0900",
            "fax_number": "915-271-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRERA",
        "first_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-28",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1011146",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1011146",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.