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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JOHNATTAN RIVERA VISALDEN MD
NPI 1649044728
Student in an Organized Health Care Education/Training Program in El Paso, TX

Active since November 09, 2023PECOS Enrolled
4615 ALAMEDA AVE, EL PASO, TX 79905(915) 215-5145 Get Directions Write a Review

NPPES record last updated: July 9, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 9, 2026, Nov 9, 2023 (2 updates tracked since 2023).

About Johnattan Rivera Visalden Md NPPES

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

JOHNATTAN RIVERA VISALDEN MD (NPI 1649044728) is an individual student in an organized health care education/training program in El Paso, Texas, licensed in Texas (BP10100566) and active in the NPI registry since November 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1649044728
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJOHNATTAN RIVERA VISALDENCredential: MD
Location Address4615 ALAMEDA AVEEl Paso, TX 79905-2702
Mailing Address4615 Alameda AveEl Paso, TX 79905-2702 · (915) 215-8000
Phone(915) 215-5145
Sole ProprietorYes
Medical School CMSOtherGraduated 2018
Enumeration DateNovember 9, 2023
Last NPPES UpdateJuly 9, 20262 updates tracked since enumeration
NPPES CertifiedJuly 9, 2026
✔ NPI 1649044728 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in TX · BP10100566
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
4615 ALAMEDA AVE, El Paso, TX 79905
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Johnattan Rivera Visalden Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2163909763
PECOS Enrollment IDI20260126001937
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.

Other Providers at the Same Location NPPES 20

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

DR. MELANIE LONGHURST PHD
Psychologist (Clinical)
4615 ALAMEDA AVE
EL PASO, TX 79905
El Paso County (915) 215-5850
HEALTH AND HUMAN SERVICES COMMISSION
Pharmacy (Long Term Care Pharmacy)
4615 ALAMEDA AVE
EL PASO, TX 79905
El Paso County (915) 534-5316
ERIKA ABIGAIL PEREDA PSYD
Psychologist (Clinical)
4615 ALAMEDA AVE
EL PASO, TX 79905
El Paso County (915) 215-5850
TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER
Psychologist
4615 ALAMEDA AVE
EL PASO, TX 79905
El Paso County (915) 545-6230
DR. IVETTE GONZALEZ-DIAZ MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
4615 ALAMEDA AVE
EL PASO, TX 79905
El Paso County (915) 215-5850
CHRISTOPHER NICHOLAS MANCHA APRN
Nurse Practitioner (Psychiatric/Mental Health)
4615 ALAMEDA AVE
EL PASO, TX 79905
El Paso County (915) 532-2202
SALVADOR F AGUIRRE M.D.
Psychiatry & Neurology (Psychiatry)
4615 ALAMEDA AVE
EL PASO, TX 79905
El Paso County (915) 545-6831
PETER M THOMPSON MD
Psychiatry & Neurology (Psychiatry)
4615 ALAMEDA AVE
EL PASO, TX 79905
El Paso County (915) 215-5850

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 Johnattan Rivera Visalden's NPI number?

The NPI number for Johnattan Rivera Visalden is 1649044728. It was assigned to this individual provider in the NPPES registry on November 9, 2023.

Where is Johnattan Rivera Visalden located?

Johnattan Rivera Visalden practices at 4615 Alameda Ave, El Paso, TX 79905. The listed phone number is (915) 215-5145.

What is Johnattan Rivera Visalden's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Johnattan Rivera Visalden enrolled in Medicare?

Yes. Johnattan Rivera Visalden is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Johnattan Rivera Visalden was last updated on July 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 38 days 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.