NPIMap

Organization Active NPI

Gastrocare of El Paso

  • Gastroenterology Physician
  • El Paso, TX
National Provider Identifier
1851763510
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
GASTROCARE OF EL PASO
Practice address
3270 Joe Battle Blvd
Ste 245
El Paso, TX 79938-2639
Phone
(915) 702-0165
Fax
(915) 702-0167
NPI assigned
Oct 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Authorized official

Name
Ikenna I Egbuna, MDNPI 1598805574
Title
Ceo
Phone
(915) 702-0165

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

3270 Joe Battle Blvd
Ste 245
El Paso, TX 79938-2639

Mailing address

3270 Joe Battle Blvd
Ste 245
El Paso, TX 79938-2639
Phone (915) 702-0165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151216000622 TX Part B Supplier - Clinic/Group Practice 2466753421 Receives reassigned benefits from 2 practitioners
Practice locations: El Paso, TX

National Provider Directory

National Provider Directory

Locations

3270 Joe Battle Blvd
Ste 245
El Paso, TX 79938
Phone (915) 594-7777

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587513600000",
    "number": "1851763510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3270 JOE BATTLE BLVD",
            "address_2": "STE 245",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799382639",
            "telephone_number": "915-702-0165",
            "fax_number": "915-702-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3270 JOE BATTLE BLVD",
            "address_2": "STE 245",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799382639",
            "telephone_number": "915-702-0165",
            "fax_number": "915-702-0167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROCARE OF EL PASO",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-21",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A",
        "authorized_official_last_name": "EGBUNA",
        "authorized_official_first_name": "IKENNA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "915-702-0165",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.