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CLINICA DE LA FAMILIA HISPANA EBENEZER LLC
NPI 1003660895
Nurse Practitioner - Family in Bedford, TX

Active since April 16, 2024
522 BEDFORD RD, BEDFORD, TX 76022(682) 738-3358(682) 738-3117 Get Directions Write a Review

NPPES record last updated: September 16, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 16, 2024, Aug 16, 2024, Aug 9, 2024 and 2 more (5 updates tracked since 2024).

About Clinica De La Familia Hispana Ebenezer Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLINICA DE LA FAMILIA HISPANA EBENEZER LLC (NPI 1003660895) is a healthcare organization registered as a family in Bedford, Texas and active in the NPI registry since April 2024. The organization lists Addel Castellanos Matos, Owner, as its authorized official.

NPPES Registry Identity

NPI1003660895
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameCLINICA DE LA FAMILIA HISPANA EBENEZER LLC
Location Address522 BEDFORD RDBedford, TX 76022-6505
Mailing Address522 Bedford RdBedford, TX 76022-6505 · (682) 738-3358 · Fax (682) 738-3117
Phone(682) 738-3358
Fax(682) 738-3117
Organization SubpartNo
Authorized OfficialAddel Castellanos MatosOwner · (682) 738-3358
Enumeration DateApril 16, 2024
Last NPPES UpdateSeptember 16, 20245 updates tracked since enumeration
NPPES CertifiedSeptember 9, 2024
✔ NPI 1003660895 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
522 BEDFORD RD, Bedford, TX 76022
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Cigna Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Clinica De La Familia Hispana Ebenezer Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Clinica De La Familia Hispana Ebenezer LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Roselio Perez Garcia, FNP
Nurse Practitioner
NPI 1043780513
2110 N GALLOWAY AVE STE 108
Mesquite, TX 75150
(972) 634-4871
✔ PECOS32 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Clinica De La Familia Hispana Ebenezer LLC's NPI number?

The NPI number for Clinica De La Familia Hispana Ebenezer LLC is 1003660895. It was assigned to this organization in the NPPES registry on April 16, 2024.

Where is Clinica De La Familia Hispana Ebenezer LLC located?

Clinica De La Familia Hispana Ebenezer LLC is located at 522 Bedford Rd, Bedford, TX 76022. The listed phone number is (682) 738-3358.

What is Clinica De La Familia Hispana Ebenezer LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Clinica De La Familia Hispana Ebenezer LLC enrolled in Medicare?

Yes. Clinica De La Familia Hispana Ebenezer LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Clinica De La Familia Hispana Ebenezer LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Clinica De La Familia Hispana Ebenezer LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Clinica De La Familia Hispana Ebenezer LLC accept?

Health plans from Blue Cross and Blue Shield of Texas and Cigna Healthcare list Clinica De La Familia Hispana Ebenezer LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Clinica De La Familia Hispana Ebenezer LLC was last updated on September 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.