Individual provider Active NPI

Nicolas Baida-Fragoso, M.D.

  • Psychiatry Physician
  • El Paso, TX
National Provider Identifier
1922214519
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
J3970 Issued in TX
Practice address
1900 Denver Ave
El Paso, TX 79902-3008
Phone
(915) 544-4000
NPI assigned
May 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X J3970 TX Primary

Addresses

Primary practice location

1900 Denver Ave
El Paso, TX 79902-3008

Mailing address

1605 George Dieter Dr Ste 636
El Paso, TX 79936-5692
Phone (915) 671-1371

Other identifiers 1

IdentifierTypeStateIssuer
169279001MedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040702000259 TX Practitioner - Psychiatry 4183601610 Reassigns benefits to 1 organization
Practice locations: El Paso, TX

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1900 Denver Ave
El Paso, TX 79902-3008
Phone (915) 671-1371

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Nicolas Baida Fragoso MD PLLC Psychiatry CurrentSince Oct 1, 2022 Accepting new patients
University Behavioral Health of El Paso, LLC Past Accepting new patients

Locations

1900 Denver Ave
El Paso, TX 79902
Phone (915) 787-6265

1605 George Dieter Dr
Ste 636
El Paso, TX 79936
Phone (915) 274-1617

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": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1922214519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 GEORGE DIETER DR STE 636",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799365692",
            "telephone_number": "915-671-1371",
            "fax_number": "915-219-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 DENVER AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799023008",
            "telephone_number": "915-544-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIDA-FRAGOSO",
        "first_name": "NICOLAS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "J3970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "169279001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.