El Paso Oncology and Internal Medicine, P.a
Organization Active NPI Internal Medicine Physician · El Paso, TX
NPI 1861522583 · NPPES record last updated Jan 17, 2024
Key facts
- NPI
- 1861522583
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- EL PASO ONCOLOGY AND INTERNAL MEDICINE, P.A
- Practice address
- 5620 Gateway Blvd E
El Paso, TX 79905-1717 - Phone
- (915) 255-9317
- Fax
- (915) 249-6275
- NPI assigned
- Mar 6, 2007
- Organization subpart
- No
Authorized official
- Name
- Norma Boeta
- Title
- Business Manager
- Phone
- (915) 255-9317
Practitioners 11
-
Armando Beltran, M.D.
-
Richard John Anaya, PAC
-
Indira Prado, FNP-C
-
Michelle Lee Calderon, FNP-C
-
Sumit Gaur, MD
-
Robert Michael Kaufman, RNFNP-C
-
Louie Leyva, F.N.P.
-
Blas Alberto Miranda, M.D.
-
Jaime Holberton Square, M.D.
-
Walter Dittel, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040727000626 | TX | Part B Supplier - Clinic/Group Practice | 9234119793 |
Receives reassigned benefits from 4 practitioners Practice locations: El Paso, TX |
National Provider Directory
Locations
5620 Gateway Blvd E
El Paso, TX 79905
Phone (915) 255-9317
5577 Alameda Ave
El Paso, TX 79905
Phone (915) 775-8587
125 N Glenwood St
Ste A
El Paso, TX 79905
Phone (915) 775-8587
2022 Murchison Dr
Ste 100
El Paso, TX 79902
Phone (915) 533-5388
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes | ||
| Hematology & Oncology Physician |
207RH0003X |
Addresses
Primary practice location
5620 Gateway Blvd E
El Paso, TX 79905-1717
Mailing address
5620 Gateway Blvd E
El Paso, TX 79905-1717
Phone (915) 255-9317
NPI Registry JSON
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1705449600000",
"number": "1861522583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5620 GATEWAY BLVD E",
"city": "EL PASO",
"state": "TX",
"postal_code": "799051717",
"telephone_number": "915-255-9317",
"fax_number": "915-249-6275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5620 GATEWAY BLVD E",
"city": "EL PASO",
"state": "TX",
"postal_code": "799051717",
"telephone_number": "915-255-9317",
"fax_number": "915-249-6275"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EL PASO ONCOLOGY AND INTERNAL MEDICINE, P.A",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-06",
"last_updated": "2024-01-17",
"certification_date": "2024-01-17",
"status": "A",
"authorized_official_last_name": "BOETA",
"authorized_official_first_name": "NORMA",
"authorized_official_title_or_position": "BUSINESS MANAGER",
"authorized_official_telephone_number": "915-255-9317"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207RH0003X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Hematology & Oncology",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in El Paso, TX
- El Paso Neurological Institute, PA
- El Paso Neurosurgery Center, P.a.
- El Paso Nursing Services, Inc.
- El Paso Nutrition Consultants LLC
- El Paso OBGYN
- El Paso Operations Healthcare Center, L.P.
- El Paso Optical, P.C.
- El Paso Oral & Facial Surgeons, PLLC
- El Paso Oral Surgery Center, PLLC
- El Paso Oral Surgery PLLC
All providers in El Paso, TX · Internal Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.