Individual provider Active NPI

Robert L. Jimenez, MD

  • Psychiatry Physician
  • San Antonio, TX
National Provider Identifier
1083713614
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
D3283 Issued in TX
Practice address
2515 McCullough Ave Ste a
San Antonio, TX 78212-3584
Phone
(210) 612-3244
Fax
(210) 637-9034
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X D3283 TX Primary

Addresses

Primary practice location

2515 McCullough Ave Ste a
San Antonio, TX 78212-3584

Mailing address

PO Box 15407
San Antonio, TX 78212-8607
Phone (210) 612-3244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Renal Associates, P.a. PastSince Dec 21, 2015 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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1083713614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15407",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782128607",
            "telephone_number": "210-612-3244",
            "fax_number": "210-637-9034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 MCCULLOUGH AVE STE A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782123584",
            "telephone_number": "210-612-3244",
            "fax_number": "210-637-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "ROBERT",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "D3283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.