Individual provider Active NPI

Thornton Samuel Mu, MD

  • Neonatal-Perinatal Medicine Physician
  • Fort Sam Houston, TX
National Provider Identifier
1013981190
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
P6473 Issued in TX
Practice address
3551 Roger Brooke Dr
McHe-QD (Creds)
Fort Sam Houston, TX 78234-4504
Phone
(210) 916-0707
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01060354A IN
Neonatal-Perinatal Medicine Physician 2080N0001X 15807 HI
Neonatal-Perinatal Medicine Physician 2080N0001X P6473 TX Primary

Addresses

Primary practice location

3551 Roger Brooke Dr
McHe-QD (Creds)
Fort Sam Houston, TX 78234-4504

Mailing address

3551 Roger Brooke Dr
Sammc, Dept of Pediatrics
Jbsa Ft Sam Houston, TX 78234-4504
Phone (210) 916-0378

Other practice location 1

5430 Fredericksburg Rd Ste 508
San Antonio, TX 78229-3561
Phone (210) 541-8281 ext. 221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110927000125 HI Practitioner - Pediatric MedicinePractitioner - Other (Physician) 4284805193 Reassigns benefits to 1 organization
I20140225000844 TX Practitioner - Pediatric Medicine 4284805193 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01060354AINMDPediatrics Physician
15807HIMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Magella Medical Associates Billing, Inc. Neonatal-Perinatal Medicine CurrentSince Dec 28, 2013 Accepting new patients
Kapiolani Medical Specialists CurrentSince Feb 11, 2015 Accepting new patients
Christus Santa Rosa Health Care Corporation Past Accepting new patients
Christus Santa Rosa Health Care Corporation Past Accepting new patients

Locations

1500 Concord Ter
Fl 5
Sunrise, FL 33323
Phone (954) 384-0175

1319 Punahou St
Honolulu, HI 96826
Phone (808) 485-4300

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

3011 W Loop 1604 N
San Antonio, TX 78251
Phone (726) 266-7081

333 N Santa Rosa
San Antonio, TX 78207
Phone (210) 704-2190

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

520 Madison Oak Dr
San Antonio, TX 78258
Phone (210) 297-0412

5430 Fredericksburg Rd
Ste 508
San Antonio, TX 78229
Phone (210) 541-8281

7930 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 297-5000

1310 McCullough Ave
San Antonio, TX 78212
Phone (210) 208-2200

1139 E Sonterra Blvd
San Antonio, TX 78258
Phone (210) 638-2000

333 N Santa Rosa
Ste 100
San Antonio, TX 78207
Phone (210) 704-3907

5106 W Loop 1604 N
San Antonio, TX 78251
Phone (210) 575-0355

3333 Research Plz
San Antonio, TX 78235
Phone (210) 297-3000

Organizations & group practices 4

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1013981190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "address_2": "SAMMC, DEPT OF PEDIATRICS",
            "city": "JBSA FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "address_2": "MCHE-QD (CREDS)",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-0707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5430 Fredericksburg Rd Ste 508",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293561",
            "country_code": "US",
            "telephone_number": "210-541-8281 x221",
            "fax_number": "210-541-9123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MU",
        "first_name": "THORNTON",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01060354A",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "HI",
            "license": "15807",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TX",
            "license": "P6473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.