Individual provider Active NPI

Candace C Burrell-Miramontes, RN, FNP-C

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1063924751
Registry record updated Apr 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP135543 Issued in TX
Practice address
9811 Huebner Rd BLDG 2
San Antonio, TX 78240-3255
Phone
(210) 533-0257
Fax
(210) 534-0890
NPI assigned
Nov 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP135543 TX Primary

Addresses

Primary practice location

9811 Huebner Rd BLDG 2
San Antonio, TX 78240-3255

Mailing address

3110 Nogalitos Ste 105
San Antonio, TX 78225-2337
Phone (210) 533-0257

Other practice location 1

3110 Nogalitos Ste 105
San Antonio, TX 78225-2337
Phone (210) 533-0257

Other identifiers 1

IdentifierTypeStateIssuer
AP135543OtherTXTEXAS BOARD OF NURSING

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
I20180116000250 TX Practitioner - Nurse Practitioner 2961761135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
David a Ramos MD PAGroup PAC ID 8729229935, 10 clinicians

Practice addresses (Care Compare)

3110 Nogalitos
105 R Family Medical Group
San Antonio, TX 78225-2337
Phone (210) 533-0257

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
David a Ramos M.D., P.a. CurrentSince Oct 23, 2017 Accepting new patients
R Family Medical Group, Inc Past Accepting new patients

Locations

9811 Huebner Rd
Bldg 2
San Antonio, TX 78240
Phone (210) 533-0257

3110 Nogalitos
Ste 105
San Antonio, TX 78225
Phone (210) 533-0257

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EGACCA

Organizations & group practices 2

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": "1509580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1063924751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 NOGALITOS STE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782252337",
            "telephone_number": "210-533-0257",
            "fax_number": "210-531-9488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9811 HUEBNER RD BLDG 2",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782403255",
            "telephone_number": "210-533-0257",
            "fax_number": "210-534-0890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3110 Nogalitos Ste 105",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782252337",
            "country_code": "US",
            "telephone_number": "210-533-0257",
            "fax_number": "210-534-0890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BURRELL-MIRAMONTES",
        "first_name": "CANDACE",
        "middle_name": "C",
        "credential": "RN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-02",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP135543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF NURSING",
            "identifier": "AP135543",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.