Individual provider Active NPI

Cecilia Pacheco, MD

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1013914811
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H3630 Issued in TX
Practice address
7500 Barlite Blvd
Ste 201
San Antonio, TX 78224-1361
Phone
(210) 921-3939
Fax
(210) 921-3941
NPI assigned
Jul 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H3630 TX Primary

Addresses

Primary practice location

7500 Barlite Blvd
Ste 201
San Antonio, TX 78224-1361

Mailing address

7500 Barlite Blvd
Ste 201
San Antonio, TX 78224-1361
Phone (210) 921-3939

Other identifiers 2

IdentifierTypeStateIssuer
117688504OtherTXWELLMED MEDICAID
TXB121163OtherTXWELLMED MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080215000221 TX Practitioner - Family Practice 4688757560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
H3630TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HMG Medical Group, P.a. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1013914811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 BARLITE BLVD",
            "address_2": "STE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782241361",
            "telephone_number": "210-921-3939",
            "fax_number": "210-921-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 BARLITE BLVD",
            "address_2": "STE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782241361",
            "telephone_number": "210-921-3939",
            "fax_number": "210-921-3941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "CECILIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H3630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED MEDICAID",
            "identifier": "117688504",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED MEDICARE",
            "identifier": "TXB121163",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.