Individual provider Active NPI

Amy L Maverick, MD

  • Hospitalist Physician
  • San Antonio, TX
National Provider Identifier
1073549689
Registry record updated Apr 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
M3316 Issued in TX
Practice address
414 Navarro St
San Antonio, TX 78205-2516
Phone
(210) 579-3036
Fax
(201) 587-8167
NPI assigned
Jun 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M3316 TX
Hospitalist Physician 208M00000X M3316 TX Primary

Addresses

Primary practice location

414 Navarro St
San Antonio, TX 78205-2516

Mailing address

PO Box 708817
Sandy, UT 84070-8817
Phone (801) 352-9500

Other identifiers 2

IdentifierTypeStateIssuer
8V1921OtherTXBCBS
P00382504OtherTXRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M3316TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group California Inc. Hospitalist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492992000000",
    "number": "1073549689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 708817",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840708817",
            "telephone_number": "801-352-9500",
            "fax_number": "801-352-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 NAVARRO ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782052516",
            "telephone_number": "210-579-3036",
            "fax_number": "201-587-8167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAVERICK",
        "first_name": "AMY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-24",
        "last_updated": "2017-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M3316",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "M3316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8V1921",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00382504",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.