NPIMap

Individual provider Active NPI

Caridad M. Rebollar, M.D.

  • Nephrology Physician
  • San Antonio, TX
National Provider Identifier
1073598520
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
K3419 Issued in TX
Practice address
2902 Goliad Rd
Suite 103
San Antonio, TX 78223-3958
Phone
(210) 337-4911
Fax
(210) 337-7749
NPI assigned
Dec 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2020

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 K3419 TX
Nephrology Physician 207RN0300X K3419 TX Primary

Addresses

Primary practice location

2902 Goliad Rd
Suite 103
San Antonio, TX 78223-3958

Mailing address

7142 San Pedro Ave
Suite 120
San Antonio, TX 78216-6254
Phone (210) 661-5622

Other practice location 1

113 Pleasant Valley Dr Ste 210
Boerne, TX 78006-5683
Phone (830) 267-4575

Other identifiers 3

IdentifierTypeStateIssuer
1182636-05MedicaidTX
118263603MedicaidTX
110207848OtherTXMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090902000221 TX Practitioner - NephrologyPractitioner - Internal Medicine 3072422823 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
University of Puerto Rico School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3124 Sidney Brooks St
Suite 570B2
San Antonio, TX 78235-5113
Phone (210) 337-4911

4115 Medical Dr
Suite 301
San Antonio, TX 78229-5622
Phone (210) 390-6911

Hospital & facility affiliations

  • DaVita Southcross Dialysis Center Dialysis facility, San Antonio, TX, CCN 672519
  • DaVita South San Antonio Dialysis Center Dialysis facility, San Antonio, TX, CCN 452747
  • DaVita The Mission Home Dialysis Dialysis facility, San Antonio, TX, CCN 742701
  • Home Nursing and Therapy Services Home health agency, San Antonio, TX, CCN 457251
  • Associates Home Health Agency Home health agency, San Antonio, TX, CCN 453158
  • Altima Home Health Agency, Inc Home health agency, San Antonio, TX, CCN 459049
  • Trinity Hospice Hospice, San Antonio, TX, CCN 741591
  • A & Z Health Care LLC Hospice, San Antonio, TX, CCN 971761
  • Caring Hands Hospice, San Antonio, TX, CCN 971540
  • Concho Hearts Hospice, LLC Hospice, San Angelo, TX, CCN 971627
  • Bridge of Life Hospice Hospice, San Antonio, TX, CCN 741713
  • Baptist Medical Center Hospital, San Antonio, TX, CCN 450058
  • Methodist Hospital Hospital, San Antonio, TX, CCN 450388
  • Westover Hills Baptist Hospital Hospital, San Antonio, TX, CCN 670333
  • Connally Memorial Medical Center Hospital, Floresville, TX, CCN 450108

Merit-based Incentive Payment System (MIPS)

Final score
85.76 of 100Reported as group
Quality
67.88
Promoting interoperability
87
Improvement activities
40
Cost
78.84

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K3419TXMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Antonio Kidney Disease Center Physicians Group, P.L.L.C. Nephrology CurrentSince Jul 5, 2000 Accepting new patients
Coe-Medical PLLC CurrentSince Jan 28, 2019 Accepting new patients
San Antonio Kidney Disease Center Physicians Group, P.L.L.C. Nephrology Past Accepting new patients

Locations

6500 Brush Country Rd
Austin, TX 78749
Phone (512) 326-1141

113 Pleasant Valley Dr
Ste 210
Boerne, TX 78006
Phone (210) 872-4710

7142 San Pedro Ave
Ste 120
San Antonio, TX 78216
Phone (210) 481-7453

3124 Sidney Brooks St
Ste 570B2
San Antonio, TX 78235
Phone (210) 337-4911

Interoperability endpoints

  • Direct secure messaging: caridadrebollar@sakdc.allscriptsdirect.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
A & Z Health Care LLCSan Antonio, TX, CCN 971761 Hospice Contracted Managing Employee Nov 2, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1073598520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7142 SAN PEDRO AVE",
            "address_2": "SUITE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166254",
            "telephone_number": "210-661-5622",
            "fax_number": "210-395-4012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2902 GOLIAD RD",
            "address_2": "SUITE 103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782233958",
            "telephone_number": "210-337-4911",
            "fax_number": "210-337-7749"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "113 Pleasant Valley Dr Ste 210",
            "address_purpose": "LOCATION",
            "city": "Boerne",
            "state": "TX",
            "postal_code": "780065683",
            "country_code": "US",
            "telephone_number": "830-267-4575",
            "fax_number": "830-267-4575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REBOLLAR",
        "first_name": "CARIDAD",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-07",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K3419",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "K3419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1182636-05",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118263603",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "110207848",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.