Organization Active NPI

Texas Spine and Orthopedic Solutions

  • Orthopaedic Surgery Physician
  • Boerne, TX
National Provider Identifier
1033772173
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
TEXAS SPINE AND ORTHOPEDIC SOLUTIONS
Practice address
1002 E Blanco Rd Ste B
Boerne, TX 78006-1802
Phone
(210) 401-1515
Fax
(210) 401-1818
NPI assigned
Apr 15, 2019
Last updated
Sep 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Authorized official

Name
Nitin Kukkar, MDNPI 1417119918
Title
Authorized Official
Phone
(217) 819-6586

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary

Addresses

Primary practice location

1002 E Blanco Rd Ste B
Boerne, TX 78006-1802

Mailing address

1806 Ayleth Ave
San Antonio, TX 78213-3975
Phone (210) 401-1515

Other practice location 1

7410 Blanco Rd Ste 101
San Antonio, TX 78216-4364
Phone (210) 401-1515

Other practice location 2

701 E Fm 1626 Ste 202
Austin, TX 78748-2656
Phone (210) 401-1515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190622000013 TX Part B Supplier - Clinic/Group Practice 9638403876 Receives reassigned benefits from 2 practitioners
Practice locations: Bee Cave, TX; Boerne, TX; Corpus Christi, TX; Laredo, TX

National Provider Directory

National Provider Directory

Locations

3944 Ranch Road 620 S
Bee Cave, TX 78738
Phone (210) 401-1515

3944 Ranch Road 620 S
Ste 207
Bee Caves, TX 78738
Phone (210) 401-1515

1580 S Main St
Ste 101
Boerne, TX 78006
Phone (210) 401-1515

1010 NW Loop 410
Ste 100A
San Antonio, TX 78213
Phone (210) 886-8031

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663632000000",
    "number": "1033772173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 AYLETH AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782133975",
            "telephone_number": "210-401-1515",
            "fax_number": "210-401-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 E BLANCO RD STE B",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780061802",
            "telephone_number": "210-401-1515",
            "fax_number": "210-401-1818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7410 Blanco Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782164364",
            "country_code": "US",
            "telephone_number": "210-401-1515",
            "fax_number": "210-401-1818",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 E Fm 1626 Ste 202",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787482656",
            "country_code": "US",
            "telephone_number": "210-401-1515",
            "fax_number": "210-401-1818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TEXAS SPINE AND ORTHOPEDIC SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-15",
        "last_updated": "2022-09-20",
        "certification_date": "2020-12-02",
        "status": "A",
        "authorized_official_last_name": "KUKKAR",
        "authorized_official_first_name": "NITIN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "217-819-6586",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.