Individual provider Active NPI

Khusrav Mirov, AGACNP

  • Acute Care Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1023989274
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1212964 Issued in TX
Practice address
1139 E Sonterra Blvd
San Antonio, TX 78258-4347
Phone
(210) 576-5401
NPI assigned
Sep 12, 2025
Last updated
Sep 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1212964 TX Primary

Addresses

Primary practice location

1139 E Sonterra Blvd
San Antonio, TX 78258-4347

Mailing address

1139 E Sonterra Blvd
San Antonio, TX 78258-4347

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251205001500 TX Practitioner - Nurse Practitioner 5294228482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Services of TX, PLLCGroup PAC ID 3274998067, 376 clinicians

Practice addresses (Care Compare)

1139 E Sonterra Blvd
San Antonio, TX 78258-4347
Phone (210) 638-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1212964TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine Services of TX, PLLC CurrentSince Oct 21, 2025 Accepting new patients

Locations

12141 Richmond Ave
Houston, TX 77082
Phone (281) 558-3444

11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000

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

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1757635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1023989274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1139 E SONTERRA BLVD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1139 E SONTERRA BLVD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584347",
            "telephone_number": "210-576-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIROV",
        "first_name": "KHUSRAV",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-12",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1212964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.