Individual provider Active NPI

Charles P Biediger, MD

  • Otolaryngology Physician
  • San Antonio, TX
National Provider Identifier
1033127022
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
J3991 Issued in TX
Practice address
19026 Stone Oak Pkwy
Suite 110
San Antonio, TX 78258-3227
Phone
(210) 545-0404
Fax
(210) 614-1003
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X J3991 TX Primary

Addresses

Primary practice location

19026 Stone Oak Pkwy
Suite 110
San Antonio, TX 78258-3227

Mailing address

PO Box 2679
San Antonio, TX 78299-2679
Phone (210) 616-0096

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
I20040614001490 TX Practitioner - Otolaryngology 3375430085 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alamo ENT Associates Otolaryngology CurrentSince Jul 1, 2004 Accepting new patients
Gundersen Clinic LTD Past Accepting new patients

Locations

7940 Floyd Curl Dr
Ste 400
San Antonio, TX 78229
Phone (210) 616-0096

19026 Stone Oak Pkwy
Ste 220
San Antonio, TX 78258

19026 Stone Oak Pkwy
Ste 110
San Antonio, TX 78258
Phone (210) 545-0404

Organizations & group practices 2

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033127022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2679",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782992679",
            "telephone_number": "210-616-0096",
            "fax_number": "210-614-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19026 STONE OAK PKWY",
            "address_2": "SUITE 110",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583227",
            "telephone_number": "210-545-0404",
            "fax_number": "210-614-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIEDIGER",
        "first_name": "CHARLES",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "J3991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.