Individual provider Active NPI

Kristan R Valdes, APRN - PMHNP - BC,

  • Psychiatric/Mental Health Nurse Practitioner
  • El Paso, TX
National Provider Identifier
1902612146
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1020722 Issued in TX
Practice address
6601 Montana Ave Ste J
El Paso, TX 79925-2143
Phone
(915) 249-6227
NPI assigned
Dec 3, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1020722 TX Primary

Addresses

Primary practice location

6601 Montana Ave Ste J
El Paso, TX 79925-2143

Mailing address

3802 Keystone St
Garland, TX 75041-5146
Phone (214) 790-6829

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
I20250211003336 TX Practitioner - Nurse Practitioner 4981134525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Ohio Medical University, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Freedom Behavioral Health Texas PLLCGroup PAC ID 9133569189, 3 clinicians

Practice addresses (Care Compare)

6601 Montana Ave
Suite J
El Paso, TX 79925-2143
Phone (915) 234-6227

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1020722TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Freedom Behavioral Health Texas PLLC CurrentSince Jan 22, 2025 Accepting new patients
Family Endeavors, Inc PastSince Dec 8, 2024 Accepting new patients

Locations

6601 Montana Ave
Ste J
El Paso, TX 79925
Phone (915) 234-6227

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1733184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1902612146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3802 KEYSTONE ST",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750415146",
            "telephone_number": "214-790-6829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 MONTANA AVE STE J",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799252143",
            "telephone_number": "915-249-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDES",
        "first_name": "KRISTAN",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "APRN - PMHNP - BC,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-03",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1020722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.