Individual provider Active NPI

Carmen NG, AGACNP-BC

  • Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1073288015
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1049992 Issued in TX
Practice address
520 E Euclid Ave
San Antonio, TX 78212-4414
Phone
(210) 581-2837
Fax
(210) 853-2718
NPI assigned
Aug 11, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 1049992 TX
Nurse Practitioner 363L00000X 1049992 TX Primary

Addresses

Primary practice location

520 E Euclid Ave
San Antonio, TX 78212-4414

Mailing address

1905 E State Highway 97
Jourdanton, TX 78026-1504

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
I20211025001665 TX Practitioner - Nurse Practitioner 7911395926 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Texas Medical School at San Antonio, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

520 E Euclid Ave
San Antonio, TX 78212-4414
Phone (210) 271-0606

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1049992TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Digestive Disease Consultants, PLLC Current Accepting new patients
South Texas Physician Services, PLLC Nurse Practitioner CurrentSince Jan 9, 2024 Accepting new patients
Bexar Physician Services, PLLC Nurse Practitioner CurrentSince Jan 2, 2024 Accepting new patients
Texas Digestive Disease Consultants PLLC CurrentSince Jul 1, 2024 Accepting new patients
Texas Digestive Disease Consultants, PLLC CurrentSince Jul 1, 2024 Accepting new patients

Locations

1275 Marvin Hancock Dr
Jasper, TX 75951
Phone (409) 384-1951

5425 W Spring Creek Pkwy
Ste 205
Plano, TX 75024
Phone (972) 526-5860

2827 Babcock Rd
San Antonio, TX 78229
Phone (210) 253-9955

520 E Euclid Ave
San Antonio, TX 78212

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, 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": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1073288015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 E STATE HIGHWAY 97",
            "city": "JOURDANTON",
            "state": "TX",
            "postal_code": "780261504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E EUCLID AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124414",
            "telephone_number": "210-581-2837",
            "fax_number": "210-853-2718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NG",
        "first_name": "CARMEN",
        "credential": "AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-11",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1049992",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1049992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.