A HEALTHY MASSAGE BY MODESTA (NPI# 1417362401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417362401 |
| Entity Type | Organization |
| Organization Name | A HEALTHY MASSAGE BY MODESTA |
| Practice Address |
9047 Polaris St El Paso TX 79904-1122 |
| Practice Telephone | 9155882167 |
| Mailing Telephone | 9155882167 |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2014-06-27 |
| Authorized Official Name | MODESTA VAN DEN BOGAARD (LICENSED MASSAGE THERAPIST) |
| Authorized Official Telephone | 9155882167 |
| Authorized Official Credential | LMT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305S00000X | Point of Service | 101448 | TX | Managed Care Organizations |
| Street Address |
9047 POLARIS ST |
| City | EL PASO |
| State | TX |
| Zip Code | 79904-1122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700385762 | Matthew Jacob Lares | Physical Therapist | 4242 Hondo Pass Drive Suite 110, El Paso, TX 79904 | 2018-02-06 |
| 1598263170 | Jennifer Suzanne Banks | Registered Nurse | 7760 Alabama Street, El Paso, TX 79904 | 2018-01-29 |
| 1508306796 | Jacqueline Gazelle Romero | Specialist/Technologist | 4601 Hondo Pass Dr Ste A, El Paso, TX 79904 | 2017-03-07 |
| 1306215967 | Dsi El Paso North, LLC | Clinic/Center | 3359 Fred Wilson Avenue, El Paso, TX 79904 | 2015-09-24 |
| 1225380587 | El Paso Eyecare Pllc | Optometrist | 9009 Gateway Blvd. South, El Paso, TX 79904 | 2012-10-11 |
| 1154617819 | Edward J Valdez | Durable Medical Equipment & Medical Supplies | 8888 Dyer St Ste 102, El Paso, TX 79904 | 2011-06-21 |
| 1548469521 | Wainwright Family Resource Center | Pediatrics | 4417 Tetons, El Paso, TX 79904 | 2007-07-11 |
| 1730256355 | Luis Raul Munoz | Pediatrics | 2900 N. Kansas St, El Paso, TX 79904 | 2006-11-29 |
| 1912012139 | Travis M Hausler | Dentist | 4721 Sierra Madre, El Paso, TX 79904 | 2006-08-20 |
| 1962422097 | Alexandra Jordan | Nurse Practitioner | 4417 Tetons Drive, El Paso, TX 79904 | 2006-07-20 |
| Find all providers in zip 79904 | ||||
| Taxonomy Code | 305S00000X |
| Grouping | Managed Care Organizations |
| Classification | Point of Service |
| This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194331660 | Veteran Mobile Labs, Pllc | Point of Service | 1633 Sora Way, El Paso, TX 79911-3053 | 2020-09-21 |
| 1265855738 | Sasfra Eye Care Inc | Point of Service | 11675 Montwood Dr Ste 3, El Paso, TX 79936-0743 | 2014-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669079174 | Matrix Medical Assistants, Pllc | Point of Service | 4518 Irvin Simmons Dr, Dallas, TX 75229-4249 | 2020-10-07 |
| 1881217149 | B&d Health Management Services | Point of Service | 100 Allentown Pkwy Ste 214, Allen, TX 75002-4220 | 2020-05-21 |
| 1912561952 | Pink Vanity Beauty Bar LLC | Point of Service | 16990 Dallas Pkwy Ste 208, Dallas, TX 75248-1935 | 2019-04-25 |
| 1265990428 | Ahsan Ansari | Point of Service | 11811 Matagorda Ln, Sugar Land, TX 77498-4640 | 2019-03-06 |
| 1639634512 | Agape Love International Foundation | Point of Service | 11614 Welshpool Glen Dr, Houston, TX 77066-4621 | 2019-02-05 |
| 1669946380 | Ahmed Mirza Fnp-c, Pllc | Point of Service | 17913 Crimson Apple Way, Pflugerville, TX 78660-2423 | 2019-01-15 |
| 1891269890 | Arauco Medical Consultants | Point of Service | 400 N Saint Paul St Ste 1200, Dallas, TX 75201-6869 | 2019-01-14 |
| 1871077446 | Novacure Group, LLC | Point of Service | 5161 San Felipe St Ste 320-18, Houston, TX 77056-3633 | 2018-09-19 |
| 1114423399 | David Rutledge Bell | Point of Service | 7301 N Ranch Road 620 Ste 155-184n, Austin, TX 78726-4539 | 2018-04-05 |
| 1417450552 | Marcellous Dunbar | Point of Service | 920 E Hwy 67, Duncanville, TX 75137-7513 | 2018-03-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.