Individual provider Active NPI

Christopher Padilla, PA-C

  • Physician Assistant
  • San Angelo, TX
National Provider Identifier
1043780539
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA12463 Issued in TX
Practice address
2626 N Bryant Blvd
San Angelo, TX 76903-2861
Phone
(325) 747-2271
NPI assigned
Nov 28, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA12463 TX Primary

Addresses

Primary practice location

2626 N Bryant Blvd
San Angelo, TX 76903-2861

Mailing address

PO Box 22000
San Angelo, TX 76902-7200
Phone (325) 658-1511

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
I20190102001770 TX Practitioner - Physician Assistant 3779828298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shannon ClinicGroup PAC ID 0840103727, 550 clinicians

Practice addresses (Care Compare)

120 E Beauregard Ave
San Angelo, TX 76903-5919
Phone (325) 747-1511

120 E Harris Ave
San Angelo, TX 76903-5904
Phone (325) 747-6741

220 E Harris Ave
San Angelo, TX 76903-5906
Phone (325) 747-1511

4251 Sunset Dr
San Angelo, TX 76904-5653
Phone (325) 747-2226

Hospital & facility affiliations

  • Shannon Medical Center Hospital, San Angelo, TX, CCN 450571

Merit-based Incentive Payment System (MIPS)

Final score
82.63 of 100Reported as group
Quality
78.21
Promoting interoperability
96
Improvement activities
40
Cost
67.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA12463TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Shannon Clinic CurrentSince Aug 1, 2022 Accepting new patients
Carl D'Agostino M.D., LTD. PastSince Jul 16, 2023 Accepting new patients
St. David'S Carenow Urgent Care PLLC Past Accepting new patients

Locations

2626 N Bryant Blvd
San Angelo, TX 76903
Phone (325) 481-2000

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1543363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1043780539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22000",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769027200",
            "telephone_number": "325-658-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 N BRYANT BLVD",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769032861",
            "telephone_number": "325-747-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADILLA",
        "first_name": "CHRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-28",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

Verify at the official NPI Registry.