Active NPI
Robert A Olivares Sr., MD
- Pain Medicine (Anesthesiology) Physician
- El Paso, TX
National Provider Identifier
1811985252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- License
- G2446
- Practice address
- 1801 N Oregon St
El Paso, TX 79902-3524 - Phone
- (915) 521-1200
- Fax
- (866) 862-5432
- NPI assigned
- Oct 10, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | G2446 | TX | Primary |
| Anesthesiology Physician | 207L00000X | G2446 | TX |
Addresses
Primary practice location
1801 N Oregon St
El Paso, TX 79902-3524
Mailing address
PO Box 203629
Dallas, TX 75320-0001
Phone (915) 533-3474
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 120287103 | Medicaid | TX | |
| V0112 | Medicaid | NM | |
| 120287102 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Imaging Consultants, P.a. | Past | Accepting new patients |
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.
-
- Diagnostic Radiology Physician
- El Paso, TX
- NPI 1659469344
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380240000000",
"number": "1811985252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 203629",
"city": "DALLAS",
"state": "TX",
"postal_code": "753200001",
"telephone_number": "915-533-3474",
"fax_number": "915-544-5037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 N OREGON ST",
"city": "EL PASO",
"state": "TX",
"postal_code": "799023524",
"telephone_number": "915-521-1200",
"fax_number": "866-862-5432"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVARES",
"first_name": "ROBERT",
"middle_name": "A",
"name_suffix": "Sr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-10",
"last_updated": "2013-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "TX",
"license": "G2446",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "TX",
"license": "G2446",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "120287103",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "V0112",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "120287102",
"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 Sep 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.