NORTH EAST FAMILY CLINIC PA
NPI 1255849097
Family Medicine in El Paso, TX

Active since January 15, 2018CLIA 45D2167309 · Waiver
9740 DYER ST STE 111&112, EL PASO, TX 79924(915) 500-5030 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 7, 2023, Jan 15, 2018 (2 updates tracked since 2018).

About North East Family Clinic Pa NPPES

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

NORTH EAST FAMILY CLINIC PA (NPI 1255849097) is a healthcare organization registered as a family medicine in El Paso, Texas and active in the NPI registry since January 2018. The organization holds a CLIA Waiver certificate valid through June 4, 2027 and lists Claudia Jacquez, Md Liasion, as its authorized official.

NPPES Registry Identity

NPI1255849097
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameNORTH EAST FAMILY CLINIC PA
Location Address9740 DYER ST STE 111&112El Paso, TX 79924-4752
Mailing Address1500 Finsterwald PlEl Paso, TX 79936-6011 · (915) 222-8747
Organization SubpartNo
Authorized OfficialClaudia JacquezMd Liasion · (915) 202-4463
Enumeration DateJanuary 15, 2018
Last NPPES UpdateMarch 7, 20232 updates tracked since enumeration
NPI 1255849097 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
9740 DYER ST STE 111&112, El Paso, TX 79924

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2167309

Northeast Family Clinic PA · El Paso, TX
Active · expires Jun 4, 2027
CLIA Number45D2167309
Laboratory TypePhysician Office
Certificate Effective DateJune 5, 2025
Certificate Expiration DateJune 4, 2027
Laboratory DirectorMauro Provencio
Laboratory Phone(915) 500-5030
Laboratory LocationNortheast Family Clinic PA9740 Dyer St. Ste 111, El Paso, TX 79924
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

Nurse Practitioner (Family)
9740 DYER ST STE 111&112
EL PASO, TX 79924
Nurse Practitioner (Family)
9740 DYER ST STE 111&112
EL PASO, TX 79924

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 North East Family Clinic PA's NPI number?

The NPI number for North East Family Clinic PA is 1255849097. It was assigned to this organization in the NPPES registry on January 15, 2018.

Where is North East Family Clinic PA located?

North East Family Clinic PA is located at 9740 Dyer St Ste 111&112, El Paso, TX 79924. The listed phone number is (915) 500-5030.

What is North East Family Clinic PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does North East Family Clinic PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2167309) is associated with this NPI, valid through June 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does North East Family Clinic PA 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 2 other insurers list North East Family Clinic PA 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 North East Family Clinic PA was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.