Individual provider Active NPI

Randy De Hoyos, PA-C

  • Physician Assistant
  • Edinburg, TX
National Provider Identifier
1902169790
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
TXPA05433 Issued in TX
Practice address
2703 W Trenton Rd
Edinburg, TX 78539-3433
Phone
(956) 682-9559
Fax
(956) 682-9768
NPI assigned
Jun 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TXPA05433 TX Primary

Addresses

Primary practice location

2703 W Trenton Rd
Edinburg, TX 78539-3433

Mailing address

2703 W Trenton Rd
Edinburg, TX 78539-3433
Phone (956) 682-9559

Other identifiers 5

IdentifierTypeStateIssuer
148060001MedicaidTX
044974601MedicaidTX
86741FMedicaidTX
143824401MedicaidTX
124348702MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
TXPA05433TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
G Athansi Orfanos MD PA PastSince Jan 19, 2020 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1902169790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2703 W TRENTON RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785393433",
            "telephone_number": "956-682-9559",
            "fax_number": "956-682-9768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2703 W TRENTON RD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785393433",
            "telephone_number": "956-682-9559",
            "fax_number": "956-682-9768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE HOYOS",
        "first_name": "RANDY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-18",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "TXPA05433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148060001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044974601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "86741F",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143824401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124348702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.