Individual provider Active NPI

Ramon Cancino, MD

  • Family Medicine Physician
  • Boerne, TX
National Provider Identifier
1053555953
Registry record updated May 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
45799 Issued in TX
Practice address
25723 Old Fredericksburg
Boerne, TX 78015
Phone
(210) 450-6800
NPI assigned
Apr 23, 2009
Last updated
May 8, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 45799 TX Primary

Addresses

Primary practice location

25723 Old Fredericksburg
Boerne, TX 78015

Mailing address

7703 Floyd Curl Dr
San Antonio, TX 78229-3901
Phone (210) 450-9000

Other identifiers 3

IdentifierTypeStateIssuer
110093613AMedicaidMA
367939101MedicaidTX
367939102OtherTXCSHCN

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
I20170125002644 TX Practitioner - Family Practice 5799934931 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

7703 Floyd Curl Dr
San Antonio, TX 78229-3901
Phone (210) 450-9000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Health Science Center at San Antonio CurrentSince Jan 10, 2017 Accepting new patients
University of Texas Health Science Center at San Antonio Family Medicine CurrentSince Jan 10, 2017 Accepting new patients
University Physicians Group Family Medicine CurrentSince Jul 1, 2022 Accepting new patients
Boston University Family Medicine, Inc. Family Medicine Past Accepting new patients

Locations

25723 Old Fredericksburg Rd
Boerne, TX 78015
Phone (210) 450-6800

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

7703 Floyd Curl Dr
#7977
San Antonio, TX 78229
Phone (210) 292-0400

7979 Wurzbach Rd
#G467
San Antonio, TX 78229
Phone (210) 450-1000

7979 Wurzbach Rd
Bldg St
San Antonio, TX 78229
Phone (210) 450-1000

7979 Wurzbach Rd
Ste G467
San Antonio, TX 78229
Phone (210) 450-1000

Interoperability endpoints

  • Direct secure messaging: rcancino25580@direct.utmsa.com

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

Hospital & facility affiliations 2

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": "1240444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494201600000",
    "number": "1053555953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293901",
            "telephone_number": "210-450-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25723 OLD FREDERICKSBURG",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "78015",
            "telephone_number": "210-450-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANCINO",
        "first_name": "RAMON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-04-23",
        "last_updated": "2017-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "45799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110093613A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "367939101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "367939102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

Verify at the official NPI Registry.