Individual provider Active NPI

Michelle Habash, DO

  • Pediatric Critical Care Medicine Physician
  • San Antonio, TX
National Provider Identifier
1083721146
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
K2916 Issued in TX
Practice address
4502 Medical Dr
San Antonio, TX 78229-4402
Phone
(210) 743-2100
Fax
(210) 702-6215
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X K2916 TX
Pediatric Critical Care Medicine Physician 2080P0203X K2916 TX Primary

Addresses

Primary practice location

4502 Medical Dr
San Antonio, TX 78229-4402

Mailing address

7703 Floyd Curl Dr # Mc7977
San Antonio, TX 78229-3901
Phone (210) 450-9000

Other identifiers 2

IdentifierTypeStateIssuer
125652108OtherTXCSHCN
125652107MedicaidTX

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
I20050617000574 TX Practitioner - Pediatric Medicine 1557305703 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K2916TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at San Antonio Pediatrics Current Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Oct 31, 2010 Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Oct 31, 2010 Accepting new patients

Locations

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

333 N Santa Rosa
San Antonio, TX 78207
Phone (210) 704-2190

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

7703 Floyd Curl Dr
#7977
San Antonio, TX 78229
Phone (210) 292-0400

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1083721146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DR # MC7977",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293901",
            "telephone_number": "210-450-9000",
            "fax_number": "210-450-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-743-2100",
            "fax_number": "210-702-6215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABASH",
        "first_name": "MICHELLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K2916",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "TX",
            "license": "K2916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "125652108",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125652107",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.