NPIMap

Organization Active NPI

Endeavor Imaging Center

  • Diagnostic Radiology Physician
  • El Paso, TX
National Provider Identifier
1992410039
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
ENDEAVOR IMAGING CENTER
Practice address
1400 George Dieter Dr Ste 110
El Paso, TX 79936-7654
Phone
(915) 213-7600
Fax
(915) 600-2711
NPI assigned
Jan 23, 2023
Last updated
Oct 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Authorized official

Name
Mr. John Camacho
Title
Owner
Phone
(915) 213-7600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary
Radiology Clinic/Center 261QR0200X

Addresses

Primary practice location

1400 George Dieter Dr Ste 110
El Paso, TX 79936-7654

Mailing address

3206 4TH St
Longview, TX 75605-5143
Phone (903) 663-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230919000493 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 3870957236 Practice locations: El Paso, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697673600000",
    "number": "1992410039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3206 4TH ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055143",
            "telephone_number": "903-663-4800",
            "fax_number": "903-663-9960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 GEORGE DIETER DR STE 110",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799367654",
            "telephone_number": "915-213-7600",
            "fax_number": "915-600-2711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDEAVOR IMAGING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A",
        "authorized_official_last_name": "CAMACHO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "915-213-7600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.