Individual provider Active NPI

Marie Therese Woznicki, AGACNP-BC

  • Acute Care Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1891231460
Registry record updated Jan 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP132011 Issued in TX
Practice address
4301 N Mesa St Ste 100
El Paso, TX 79902-1118
Phone
(915) 532-6767
NPI assigned
Jan 6, 2017
Last updated
Jan 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP132011 TX Primary

Addresses

Primary practice location

4301 N Mesa St Ste 100
El Paso, TX 79902-1118

Mailing address

4301 N Mesa St Ste 100
El Paso, TX 79902-1118
Phone (915) 532-6767

Other names 1

  • Marie Broussard Former name

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
I20170208000468 TX Practitioner - Nurse Practitioner 2961785480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
El Paso Cardiology Associates, P.a.Group PAC ID 9335130137, 24 clinicians

Practice addresses (Care Compare)

7450 Remcon Cir
El Paso, TX 79912-3508
Phone (915) 532-6767

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP132011TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
El Paso Cardiology Associates, P.a. CurrentSince Jan 1, 2017 Accepting new patients
Michael J Deluca MD PA Past Accepting new patients

Locations

1418 George Dieter Dr
Ste 210
El Paso, TX 79936
Phone (915) 532-6767

4301 N Mesa St
Ste 100
El Paso, TX 79902
Phone (915) 532-6767

7450 Remcon Cir
El Paso, TX 79912
Phone (915) 532-6767

Organizations & group practices 2

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1483660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483660800000",
    "number": "1891231460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 N MESA ST STE 100",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799021118",
            "telephone_number": "915-532-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 N MESA ST STE 100",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799021118",
            "telephone_number": "915-532-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOZNICKI",
        "first_name": "MARIE",
        "middle_name": "THERESE",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-06",
        "last_updated": "2017-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP132011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIE",
            "last_name": "BROUSSARD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.