Individual ProviderSidhartha Gautam SenapatiInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address4800 Alberta Ave, El Paso, TX 79905-2700(915) 215-4116PECOS EnrollmentBased on the most recent information from CMS, provider Sidhartha Gautam Senapati does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1124713359Provider TypeIndividualFull NameSenapati, Sidhartha GautamGenderMaleSole ProprietorNoEnumeration Date4/5/2023Last Updated6/20/2023Contact InformationPractice LocationPractice Address4800 Alberta Ave, El Paso, TX 79905-2700Phone(915) 215-4116FaxUnlisted FaxMailing LocationMailing Address4800 Alberta Ave, El Paso, TX 79905-2700Phone(915) 215-4116FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseBP10085726TexasCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer