Sun City Sports Medicine and Family Clinic, PA
NPI 1114289956 · Sports Medicine (Family Medicine) Physician · El Paso, TX
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Sun City Sports Medicine and Family Clinic, PA is a Sports Medicine (Family Medicine) Physician organization in El Paso, TX (NPI 1114289956).
Provider details
- NPI number
- 1114289956
- Entity type
- Organization
- Primary specialty
- Sports Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mauro Provencio, Md/Owner(915) 525-3209
- License
- P1809 (TX)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2012-06-07
- Last updated
- 2024-06-18
- Certified
- 2024-06-18
Frequently asked questions
- What is Sun City Sports Medicine and Family Clinic, PA's NPI number?
- Sun City Sports Medicine and Family Clinic, PA's National Provider Identifier (NPI) is 1114289956, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Sun City Sports Medicine and Family Clinic, PA?
- Sun City Sports Medicine and Family Clinic, PA is classified in the NPPES registry as Sports Medicine (Family Medicine) Physician (Allopathic & Osteopathic Physicians).
- Where is Sun City Sports Medicine and Family Clinic, PA located?
- Sun City Sports Medicine and Family Clinic, PA's practice location on file with NPPES is 12810 Edgemere Blvd, El Paso, TX 79938-4532.
- What is Sun City Sports Medicine and Family Clinic, PA's phone number?
- The practice phone number listed in the NPPES registry for Sun City Sports Medicine and Family Clinic, PA is (915) 504-6955.
- Does Sun City Sports Medicine and Family Clinic, PA accept Medicare?
- Sun City Sports Medicine and Family Clinic, PA is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Sun City Sports Medicine and Family Clinic, PA?
- The authorized official listed on Sun City Sports Medicine and Family Clinic, PA's NPPES record is Mauro Provencio, Md/Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Sun City Sports Medicine and Family Clinic, PA's NPI active?
- Yes — Sun City Sports Medicine and Family Clinic, PA's NPI (1114289956) is active in the NPPES registry as of the last update on 2024-06-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.