Individual provider Active NPI

Anacani Fonseca, MD

  • Developmental - Behavioral Pediatrics Physician
  • El Paso, TX
National Provider Identifier
1972810539
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
R3841 Issued in TX
Practice address
840 E Redd Rd BLDG 3
El Paso, TX 79912-7265
Phone
(915) 270-8057
Fax
(888) 268-4808
NPI assigned
Sep 2, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0006X R3841 TX Primary

Addresses

Primary practice location

840 E Redd Rd BLDG 3
El Paso, TX 79912-7265

Mailing address

840 E Redd Rd BLDG 3
El Paso, TX 79912-7265
Phone (915) 270-8057

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
I20170823000878 TX Practitioner - Pediatric Medicine 5193947794 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R3841TXMDDevelopmental - Behavioral Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center El Paso Single Specialty Current Accepting new patients
Texas Tech University Health Sciences Center El Paso Single Specialty CurrentSince Aug 1, 2017 Accepting new patients
Developmental Behavioral Pediatrics of El Paso Developmental - Behavioral Pediatrics CurrentSince Sep 10, 2023 Accepting new patients
Texas Tech University Health Sciences Center El Paso Single Specialty CurrentSince Aug 1, 2017 Accepting new patients

Locations

840 E Redd Rd
Bldg 3
El Paso, TX 79912
Phone (915) 270-8057

4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200

1201 E Schuster Ave
Bldg 7
El Paso, TX 79902
Phone (915) 229-6448

4800 Alberta Ave
#21004
El Paso, TX 79905

Interoperability endpoints

  • Direct secure messaging: anacani.fonseca@direct.myhealthep.org

Organizations & group practices 4

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": "1283385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1972810539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 E REDD RD BLDG 3",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799127265",
            "telephone_number": "915-270-8057",
            "fax_number": "888-268-4808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 E REDD RD BLDG 3",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799127265",
            "telephone_number": "915-270-8057",
            "fax_number": "888-268-4808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONSECA",
        "first_name": "ANACANI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-02",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "TX",
            "license": "R3841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.