Individual provider Active NPI

Wesley Allen Clarkson, D.O.

  • Cardiovascular Disease Physician
  • San Antonio, TX
National Provider Identifier
1073585188
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
N4356 Issued in TX
Practice address
1715 McCullough Ave
FL 2
San Antonio, TX 78212-4046
Phone
(210) 408-1613
Fax
(210) 408-1613
NPI assigned
Feb 2, 2006
Last updated
Sep 14, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X N4356 TX Primary
Cardiovascular Disease Physician 207RC0000X 2002010420 MO

Addresses

Primary practice location

1715 McCullough Ave
FL 2
San Antonio, TX 78212-4046

Mailing address

1715 McCullough Ave
FL 2
San Antonio, TX 78212-4046
Phone (210) 408-1613

Other practice location 1

4411 Medical Dr Ste 300
San Antonio, TX 78229-3824
Phone (210) 614-5400

Other identifiers 2

IdentifierTypeStateIssuer
288295301MedicaidTX
8DC182OtherTXBCBS

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
I20110823000043 TX Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8820268238 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmed Networks, Inc.Group PAC ID 6002091261, 116 clinicians
Cardiology Clinic of San Antonio, PLLCGroup PAC ID 1153517420, 125 clinicians

Practice addresses (Care Compare)

1715 McCullough Ave
FL 2
San Antonio, TX 78212-4046
Phone (210) 732-3668

4411 Medical Dr
Suite 200
San Antonio, TX 78229-3824
Phone (210) 575-4584

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.32 of 100Reported as group
Quality
75.23
Promoting interoperability
99
Improvement activities
40
Cost
76.31

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N4356TXMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Networks, Inc. Cardiovascular Disease CurrentSince Jul 6, 2021 Accepting new patients
Methodist Medical Group, PLLC Cardiovascular Disease Past Accepting new patients

Locations

1715 McCullough Ave
Fl 2
San Antonio, TX 78212
Phone (210) 558-0122

4330 Medical Dr
Ste 500
San Antonio, TX 78229
Phone (210) 558-0122

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Interoperability endpoints

  • Direct secure messaging: wesley.clarkson@wellmed.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1073585188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 MCCULLOUGH AVE",
            "address_2": "FL 2",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124046",
            "telephone_number": "210-408-1613",
            "fax_number": "210-408-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 MCCULLOUGH AVE",
            "address_2": "FL 2",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124046",
            "telephone_number": "210-408-1613",
            "fax_number": "210-408-1613"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4411 Medical Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293824",
            "country_code": "US",
            "telephone_number": "210-614-5400",
            "fax_number": "210-614-2413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARKSON",
        "first_name": "WESLEY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "N4356",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MO",
            "license": "2002010420",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "288295301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8DC182",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.