Individual provider Active NPI

Jefferey Ruy Vazquez, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • El Paso, TX
National Provider Identifier
1801830997
Registry record updated Oct 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
1629 Issued in TX
Practice address
10470 Vista del Sol Dr
Suite 211
El Paso, TX 79925-7948
Phone
(915) 592-4173
Fax
(915) 592-4174
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2008

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 1629 TX Primary

Addresses

Primary practice location

10470 Vista del Sol Dr
Suite 211
El Paso, TX 79925-7948

Mailing address

PO Box 370375
El Paso, TX 79937-0375
Phone (915) 592-4173

Other identifiers 1

IdentifierTypeStateIssuer
166444301MedicaidTX

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
I20040618000655 TX Practitioner - Podiatry 8325023054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10470 Vista del Sol Dr
Suite 211
El Paso, TX 79925-7928
Phone (915) 592-4173

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue219
Removal or shaving of skin growth55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1629TXMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot Healthcare Center of El Paso, P.a. Foot & Ankle Surgery CurrentSince Mar 23, 2004 Accepting new patients

Locations

10470 Vista del Sol Dr
Ste 211
El Paso, TX 79925
Phone (915) 592-4155

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224201600000",
    "number": "1801830997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370375",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799370375",
            "telephone_number": "915-592-4173",
            "fax_number": "915-592-4174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10470 VISTA DEL SOL DR",
            "address_2": "SUITE 211",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799257948",
            "telephone_number": "915-592-4173",
            "fax_number": "915-592-4174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "JEFFEREY",
        "middle_name": "RUY",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2008-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "1629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166444301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.