Individual provider Active NPI

Malcolm James Solley, M.D

  • Emergency Medicine Physician
  • San Antonio, TX
National Provider Identifier
1063522829
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
Q0368 Issued in TX
Practice address
22250 Bulverde Rd Ste 120
San Antonio, TX 78261-3082
Phone
(210) 401-8185
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME100702 FL
Emergency Medicine Physician 207P00000X Q0368 TX Primary

Addresses

Primary practice location

22250 Bulverde Rd Ste 120
San Antonio, TX 78261-3082

Mailing address

22250 Bulverde Rd Ste 120
San Antonio, TX 78261-3082
Phone (210) 401-8185

Other identifiers 2

IdentifierTypeStateIssuer
03829OtherFLBLUE SHIELD
000647800MedicaidFL

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
I20170717000352 TX Practitioner - Internal MedicinePractitioner - Emergency Medicine 5496818478 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Providers Group LLC Emergency Medicine Past Accepting new patients
4MD2 Physician Services of Fort Walton Beach LLC Emergency Medicine Past Accepting new patients
Complete Emergency Care I LLC Past Accepting new patients
22250 Bulverde Cec Fossil Creek LLC Past Accepting new patients

Organizations & group practices 5

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1063522829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22250 BULVERDE RD STE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782613082",
            "telephone_number": "210-401-8185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 BULVERDE RD STE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782613082",
            "telephone_number": "210-401-8185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLLEY",
        "first_name": "MALCOLM",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME100702",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q0368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "03829",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000647800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.