Individual provider Active NPI

Karl Max Richard, PA-C

  • Medical Physician Assistant
  • El Paso, TX
National Provider Identifier
1962748871
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA14624 Issued in TX
Practice address
500 W Overland Ave
El Paso, TX 79901-1085
Phone
(915) 373-1230
NPI assigned
Dec 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA64213 CA
Medical Physician Assistant 363AM0700X 0010-6404 NC
Medical Physician Assistant 363AM0700X PA14624 TX Primary

Addresses

Primary practice location

500 W Overland Ave
El Paso, TX 79901-1085

Mailing address

500 W Overland Ave
El Paso, TX 79901-1085
Phone (915) 373-1230

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
I20250331003376 TX Practitioner - Physician Assistant 0840578522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VMD Primary Providers of West Texas PLLCGroup PAC ID 7810327384, 29 clinicians

Practice addresses (Care Compare)

8045 N Loop Dr
Suite a
El Paso, TX 79915-3227
Phone (915) 248-1793

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA64213CAMDMedical Physician Assistant
0010-6404NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group Arizona LLC Past Accepting new patients

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": "1355961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1962748871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W OVERLAND AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799011085",
            "telephone_number": "915-373-1230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W OVERLAND AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799011085",
            "telephone_number": "915-373-1230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARD",
        "first_name": "KARL",
        "middle_name": "MAX",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-20",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA64213",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-6404",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA14624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.