Individual provider Active NPI

Jesika Renee Perez

  • Family Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1861157257
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1059051 Issued in TX
Practice address
4815 Alameda Ave
El Paso, TX 79905-2705
Phone
(915) 215-4600
Fax
(915) 545-7338
NPI assigned
Nov 1, 2021
Last updated
Nov 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1059051 TX Primary

Addresses

Primary practice location

4815 Alameda Ave
El Paso, TX 79905-2705

Mailing address

5130 Gateway Blvd E # 51015
El Paso, TX 79905-1608
Phone (915) 215-4480

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211206000823 TX Practitioner - Nurse Practitioner 4082004023 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chauburg PLLC CurrentSince Feb 18, 2024 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Aug 24, 2021 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Aug 24, 2021 Accepting new patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients

Locations

1618 N Lee Trevino Dr
Ste D
El Paso, TX 79936
Phone (206) 703-2204

3051 N Zaragoza Rd
El Paso, TX 79938
Phone (915) 227-8065

4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200

4815 Alameda Ave
El Paso, TX 79905
Phone (915) 215-6000

Interoperability endpoints

  • Direct secure messaging: jesika.perez.1@32563.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1861157257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 GATEWAY BLVD E # 51015",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799051608",
            "telephone_number": "915-215-4480",
            "fax_number": "915-215-5386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 ALAMEDA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052705",
            "telephone_number": "915-215-4600",
            "fax_number": "915-545-7338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JESIKA",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-01",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1059051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.