Individual provider Active NPI

Jewel Marie Datri, MD, MPH

  • Internal Medicine Physician
  • San Antonio, TX
National Provider Identifier
1063091601
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
V4359 Issued in TX
Practice address
540 Madison Oak Dr Ste 370
San Antonio, TX 78258-3931
Phone
(210) 943-9578
Fax
(833) 455-6929
NPI assigned
Apr 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X V4359 TX Primary

Addresses

Primary practice location

540 Madison Oak Dr Ste 370
San Antonio, TX 78258-3931

Mailing address

540 Madison Oak Dr Ste 370
San Antonio, TX 78258-3931
Phone (210) 943-9578

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
I20241121004852 TX Practitioner - Internal Medicine 2567861487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in New Orleans, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1102 Barclay St
San Antonio, TX 78207-7161
Phone (210) 434-2368

8210 Callaghan Rd
San Antonio, TX 78230-4775
Phone (210) 233-7000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Nov 15, 2024 Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Nov 15, 2024 Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. Current Accepting new patients

Locations

1102 Barclay St
San Antonio, TX 78207
Phone (210) 434-0513

14625 Huebner Rd
San Antonio, TX 78230

8210 Callaghan Rd
San Antonio, TX 78230

3066 E Commerce St
San Antonio, TX 78220
Phone (210) 233-7062

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.

NPI Registry JSON

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1063091601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 MADISON OAK DR STE 370",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583931",
            "telephone_number": "210-943-9578",
            "fax_number": "833-455-6929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 MADISON OAK DR STE 370",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583931",
            "telephone_number": "210-943-9578",
            "fax_number": "833-455-6929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATRI",
        "first_name": "JEWEL",
        "middle_name": "MARIE",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "V4359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.