Individual provider Active NPI

Santosh Subramanyam, M.D.

  • Nephrology Physician
  • San Antonio, TX
National Provider Identifier
1053847640
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
V1902 Issued in TX
Practice address
4458 Medical Dr Ste 505
San Antonio, TX 78229-3748
Phone
(210) 690-7400
NPI assigned
May 3, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X V1902 TX
Nephrology Physician 207RN0300X V1902 TX Primary

Addresses

Primary practice location

4458 Medical Dr Ste 505
San Antonio, TX 78229-3748

Mailing address

4458 Medical Dr Ste 505
San Antonio, TX 78229-3748
Phone (210) 690-7400

Other practice location 1

1900 University Blvd # 633
Birmingham, AL 35233-2060
Phone (205) 934-7023

Other practice location 2

200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

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
I20240808002406 TX Practitioner - NephrologyPractitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 2769803253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Critical Care (Intensivists)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Ips LLCGroup PAC ID 9638356801, 44 clinicians

Practice addresses (Care Compare)

4458 Medical Dr
Suite 505
San Antonio, TX 78229-3748
Phone (210) 690-7400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
V1902TXMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Ips LLC Critical Care Medicine CurrentSince Jun 3, 2024 Accepting new patients

Locations

34910 Interstate 10 W
Ste 601
Boerne, TX 78006
Phone (830) 248-1207

4499 Medical Dr
Ste 150
San Antonio, TX 78229
Phone (210) 614-8181

1434 E Sonterra Blvd
Ste 210
San Antonio, TX 78258
Phone (210) 481-3119

4499 Medical Dr
San Antonio, TX 78229
Phone (210) 575-4325

4458 Medical Dr
Ste 505
San Antonio, TX 78229

4499 Medical Dr
#150
San Antonio, TX 78229
Phone (210) 614-8181

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1053847640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4458 MEDICAL DR STE 505",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293748",
            "telephone_number": "210-690-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4458 MEDICAL DR STE 505",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293748",
            "telephone_number": "210-690-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 University Blvd # 633",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352332060",
            "country_code": "US",
            "telephone_number": "205-934-7023",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUBRAMANYAM",
        "first_name": "SANTOSH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-03",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TX",
            "license": "V1902",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "V1902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.