Pediatric Gi Of El Paso, Pllc is a medicare enrolled "Pediatrics - Pediatric Gastroenterology" provider in El Paso, Texas. Their current practice location is
10470 Vista Del Sol Dr Ste 100, El Paso, Texas. You can reach out to their office (for appointments etc.) via phone at
(915) 615-7005.
Pediatric Gi Of El Paso, Pllc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Pediatric Gi Of El Paso, Pllc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1689262313.
Healthcare Provider's Profile
| Full Name | Pediatric Gi Of El Paso, Pllc |
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| Type | Facility |
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| Speciality | Pediatrics - Pediatric Gastroenterology |
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| Location | 10470 Vista Del Sol Dr Ste 100, El Paso, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1689262313
- Provider Enumeration Date: 01/07/2021
- Last Update Date: 10/20/2025
Medicare PECOS Information:
- PECOS PAC ID: 3678949708
- Enrollment ID: O20221014001262
Medical Identifiers
Medical identifiers for Pediatric Gi Of El Paso, Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1689262313 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Secondary |
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Secondary |
| 363LP0200X | Nurse Practitioner - Pediatrics | (* (Not Available)) | Secondary |
| 2080P0206X | Pediatrics - Pediatric Gastroenterology | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Pediatric Gi Of El Paso, Pllc acts as a billing entity for following providers:
| Provider Name | Eduardo Daniel Rosas Blum |
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| Provider Type | Practitioner - Pediatric Medicine |
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| Provider Identifiers | NPI Number: 1316133218
PECOS PAC ID: 7719147610
Enrollment ID: I20120330000433 |
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| Provider Name | Nydia Orosco |
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| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
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| Provider Identifiers | NPI Number: 1104271402
PECOS PAC ID: 7719278423
Enrollment ID: I20160627001470 |
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| Provider Name | Ali Marie Levine |
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| Provider Type | Practitioner - Qualified Speech Language Pathologist |
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| Provider Identifiers | NPI Number: 1356735492
PECOS PAC ID: 9931572864
Enrollment ID: I20230223002551 |
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| Provider Name | Viviana Amanda Dominguez |
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| Provider Type | Practitioner - Qualified Speech Language Pathologist |
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| Provider Identifiers | NPI Number: 1790355436
PECOS PAC ID: 3678010543
Enrollment ID: I20240809000167 |
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| Provider Name | Norbert Donias |
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| Provider Type | Practitioner - Pediatric Medicine |
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| Provider Identifiers | NPI Number: 1780147017
PECOS PAC ID: 6709265531
Enrollment ID: I20250311001008 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Pediatric Gi Of El Paso, Pllc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Pediatric Gi Of El Paso, Pllc
10470 Vista Del Sol Dr Ste 100,
El Paso, TX 79925-7928
Ph: (915) 615-7005 | Pediatric Gi Of El Paso, Pllc
10470 Vista Del Sol Dr Ste 100,
El Paso, TX 79925-7928
Ph: (915) 615-7005 |
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