Individual provider Active NPI

Kari Jane Teraguchi, M.D.

  • Pediatrics Physician
  • San Antonio, TX
National Provider Identifier
1073685095
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
V2579 Issued in TX
Practice address
14100 San Pedro Ave Ste 600
San Antonio, TX 78232-4363
Phone
(210) 281-8669
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 214610 NY
Pediatrics Physician 208000000X V2579 TX Primary
Pediatrics Physician 208000000X 25MA07829800 NJ

Addresses

Primary practice location

14100 San Pedro Ave Ste 600
San Antonio, TX 78232-4363

Mailing address

18018 Overlook Loop Ste 105-307
San Antonio, TX 78259-1882
Phone (917) 533-8206

Other practice location 1

21727 Ih 10 W
San Antonio, TX 78257-2106
Phone (210) 698-7663

Other identifiers 3

IdentifierTypeStateIssuer
V2579OtherTXSTATE OF TEXAS
214610OtherNYSTATE MEDICAL LICENSE NUM
25MA07829800OtherNJSTATE OF NEW JERSEY

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
I20250612002320 TX Practitioner - Pediatric Medicine 4587085014 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
214610NYMDPediatrics Physician
V2579TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Aug 4, 2025 Accepting new patients
Christus Trinity Clinic Texas Pediatrics CurrentSince Aug 4, 2025 Accepting new patients
Humc Opco LLC Current Accepting new patients
Advocare, LLC Pediatrics Past Accepting new patients

Locations

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: kari.teraguchi@direct.hobokenumc.md
  • Direct secure messaging: kteraguchi592108@christushealth.direct-ci.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1073685095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18018 OVERLOOK LOOP STE 105-307",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782591882",
            "telephone_number": "917-533-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14100 SAN PEDRO AVE STE 600",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782324363",
            "telephone_number": "210-281-8669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21727 Ih 10 W",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782572106",
            "country_code": "US",
            "telephone_number": "210-698-7663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TERAGUCHI",
        "first_name": "KARI",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "214610",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "V2579",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA07829800",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF TEXAS",
            "identifier": "V2579",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE NUM",
            "identifier": "214610",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NEW JERSEY",
            "identifier": "25MA07829800",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.