Individual provider Active NPI

Lauren Siwald Pokorny, PA-C

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1063954857
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10900 Issued in TX
Practice address
110 E Houston St FL 7
San Antonio, TX 78205-2991
Phone
(210) 572-4931
NPI assigned
Nov 9, 2016
Last updated
Oct 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10900 TX Primary

Addresses

Primary practice location

110 E Houston St FL 7
San Antonio, TX 78205-2991

Mailing address

23011 Copper Gully
San Antonio, TX 78259-2454
Phone (832) 474-3270

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
I20170117001933 TX Practitioner - Physician Assistant 9537441001 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA10900TXMDPhysician Assistant

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

NPI Registry JSON

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

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666569600000",
    "number": "1063954857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23011 COPPER GULLY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782592454",
            "telephone_number": "832-474-3270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E HOUSTON ST FL 7",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782052991",
            "telephone_number": "210-572-4931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POKORNY",
        "first_name": "LAUREN",
        "middle_name": "SIWALD",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-09",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.