Active NPI
Carlos A. Jesurun, M.D.
- Neonatal-Perinatal Medicine Physician
- El Paso, TX
National Provider Identifier
1841303427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- E1877
- Practice address
- 4800 Alberta Ave
El Paso, TX 79905-2709 - Phone
- (915) 545-6817
- Fax
- (915) 545-9799
- NPI assigned
- Aug 16, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | E1877 | TX | |
| Neonatal-Perinatal Medicine Physician | 2080N0001X | E1877 | TX | Primary |
Addresses
Primary practice location
4800 Alberta Ave
El Paso, TX 79905-2709
Mailing address
PO Box 9520
El Paso, TX 79995-9520
Phone (915) 545-6810
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 135094406 | Medicaid | TX |
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E1877 | TX | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatrix Medical Group of Texas Billing, Inc. | Pediatrics | Current | Accepting new patients |
Locations
2001 N Oregon St
El Paso, TX 79902
Phone (915) 577-6011
3001 George Bush Hwy
Ste 250
Richardson, TX 75082
Phone (888) 822-2855
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.
-
- Neonatal-Perinatal Medicine Physician
- Houston, TX
- NPI 1649377359
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226880000000",
"number": "1841303427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9520",
"city": "EL PASO",
"state": "TX",
"postal_code": "799959520",
"telephone_number": "915-545-6810",
"fax_number": "915-783-8187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 ALBERTA AVE",
"city": "EL PASO",
"state": "TX",
"postal_code": "799052709",
"telephone_number": "915-545-6817",
"fax_number": "915-545-9799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JESURUN",
"first_name": "CARLOS",
"middle_name": "A.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2008-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "E1877",
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "TX",
"license": "E1877",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "135094406",
"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 Nov 17, 2008; 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.