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HUMBERTO BALDERRAMA FNP-C
NPI 1215441886
Nurse Practitioner - Family in El Paso, TX

Active since November 19, 2017PECOS EnrolledAccepts Medicare Assignment
1250 E CLIFF DR STE 2B, EL PASO, TX 79902(915) 351-7200(915) 351-7201 Get Directions Write a Review

NPPES record last updated: March 12, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 12, 2019, Jan 18, 2018, Nov 19, 2017 (3 updates tracked since 2017).

About Humberto Balderrama Fnp-c NPPES

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

HUMBERTO BALDERRAMA FNP-C (NPI 1215441886) is an individual family provider in El Paso, Texas, licensed in Texas (AP135541) and active in the NPI registry since November 2017. He is enrolled in Medicare PECOS, is affiliated with The Hospitals Of Providence Transmountain Campus, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1215441886
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameHUMBERTO BALDERRAMACredential: FNP-C
Location Address1250 E CLIFF DR STE 2BEl Paso, TX 79902-4848
Mailing Address1250 E Cliff Dr Ste 2bEl Paso, TX 79902-4848 · (915) 351-7200 · Fax (915) 351-7201
Phone(915) 351-7200
Fax(915) 351-7201
Sole ProprietorYes
Medical School CMSOtherGraduated 2017
Enumeration DateNovember 19, 2017
Last NPPES UpdateMarch 12, 20193 updates tracked since enumeration
✔ NPI 1215441886 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
License✔ Licensed in TX · AP135541
1250 E CLIFF DR STE 2B, El Paso, TX 79902
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Humberto Balderrama Fnp-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1456611961
PECOS Enrollment IDI20180201000459
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Humberto Balderrama reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Centro San Vicente
8.5 mi
Federally Qualified Health Center (FQHC)
8061 ALAMEDA AVE
El Paso, TX 79915
  • Reassigned Medicare billing, Texas enrollment
  • 40 clinicians in this Medicare group
NPI 1831267079 (915) 859-7545
Bhs Physicians Network, Inc
498 mi
Family Medicine
502 MADISON OAK DR STE 310
San Antonio, TX 78258
  • Reassigned Medicare billing, Texas enrollment
  • 964 clinicians in this Medicare group
NPI 1598958431 (210) 483-8883

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

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
98 services70 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
19 services19 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
15 services14 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

The Hospitals Of Providence Transmountain Campus

Acute Care Hospitals · El Paso, TX
1/5 CMS rating
OwnershipProprietary
CMS Certification Number670120
Location2000 Transmountain RdEl Paso, TX 79911 · El Paso County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 79902 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RUBEN RAMIREZ M.D.
Internal Medicine (Gastroenterology)
1250 E CLIFF DR STE 2B
EL PASO, TX 79902
El Paso County (915) 356-3939

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 Humberto Balderrama's NPI number?

The NPI number for Humberto Balderrama is 1215441886. It was assigned to this individual provider in the NPPES registry on November 19, 2017.

Where is Humberto Balderrama located?

Humberto Balderrama practices at 1250 E Cliff Dr Ste 2B, El Paso, TX 79902. The listed phone number is (915) 351-7200.

What is Humberto Balderrama's specialty?

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

Is Humberto Balderrama enrolled in Medicare?

Yes. Humberto Balderrama is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Humberto Balderrama's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Humberto Balderrama reassigns Medicare benefits to 2 organizations: Centro San Vicente (El Paso, TX) and Bhs Physicians Network, Inc (San Antonio, TX). Each 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 Humberto Balderrama's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Humberto Balderrama accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 6 other insurers list Humberto Balderrama 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.

Is Humberto Balderrama affiliated with any hospitals?

According to CMS data, Humberto Balderrama is affiliated with The Hospitals Of Providence Transmountain Campus.

When was this NPI record last updated?

The NPPES record for Humberto Balderrama was last updated on March 12, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.