Individual provider Active NPI

Cynthia Felizardo, PA-C, ATC

  • Physician Assistant
  • Odessa, TX
National Provider Identifier
1992213631
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18322 Issued in TX
Practice address
4060 Medical Park Dr
Odessa, TX 79765-2233
Phone
(432) 582-2882
NPI assigned
Jan 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA18322 TX Primary

Addresses

Primary practice location

4060 Medical Park Dr
Odessa, TX 79765-2233

Mailing address

1301 Overshine LN
Midland, TX 79705-2240
Phone (203) 470-6005

Other practice location 1

62 Barnum Rd
Danbury, CT 06811-2938
Phone (203) 470-6005

Other identifiers 1

IdentifierTypeStateIssuer
003475336MedicaidCT

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
I20241025000783 TX Practitioner - Physician Assistant 5799218038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Francisco J. Salcido, M.D. P.a.Group PAC ID 7618152281, 8 clinicians

Practice addresses (Care Compare)

4060 Medical Park Dr
Odessa, TX 79765-2233
Phone 43258222822

460 Medical Park Dr
Odessa, TX 79765-2233

710 E 6TH St
Odessa, TX 79761-4655
Phone (432) 582-2882

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA18322TXMDPhysician Assistant

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": "1516060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1992213631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 OVERSHINE LN",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797052240",
            "telephone_number": "203-470-6005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 MEDICAL PARK DR",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797652233",
            "telephone_number": "432-582-2882"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "62 Barnum Rd",
            "address_purpose": "LOCATION",
            "city": "Danbury",
            "state": "CT",
            "postal_code": "068112938",
            "country_code": "US",
            "telephone_number": "203-470-6005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FELIZARDO",
        "first_name": "CYNTHIA",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-16",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003475336",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.