El Paso Radiation Medicine, P.a.

Primary specialty

Therapeutic Radiology PhysicianTaxonomy code 2085R0203X

License

L8679 Issued in TX

Legal business name

EL PASO RADIATION MEDICINE, P.A.

Practice address

1401 W Expressway 83
San Benito Cancer Center
San Benito, TX 78586-7770

Phone

(856) 685-0114

NPI assigned

Oct 17, 2007

Last updated

Dec 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bruce Elkin Ellerin, M.D.NPI 1285635052

Title

President

Phone

(856) 685-0114

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bruce Elkin Ellerin, M.D.

  • Radiation Oncology Physician
  • Tyler, TX
  • NPI 1285635052
  NPD (past) Authorized official

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228694400000",
    "number": "1841489622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 COBBLE CREEK CIR",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031838",
            "telephone_number": "856-685-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W EXPRESSWAY 83",
            "address_2": "SAN BENITO CANCER CENTER",
            "city": "SAN BENITO",
            "state": "TX",
            "postal_code": "785867770",
            "telephone_number": "856-685-0114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL PASO RADIATION MEDICINE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2008-12-08",
        "status": "A",
        "authorized_official_last_name": "ELLERIN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "ELKIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-685-0114",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0203X",
            "taxonomy_group": "",
            "desc": "Radiology, Therapeutic Radiology",
            "state": "TX",
            "license": "L8679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "00Z153",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Eldercare Home Health and Hospice (Eldercare Home Health II)
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• Bernardino Octavio Elizondo, DDS
• Nora Elizondo

• Therapeutic Radiology Physician in San Benito, TX
• Providers in San Benito, TX by specialty
• Therapeutic Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.