Active NPI
Kathy Ann Lacivita, MD
- Endocrinology, Diabetes & Metabolism Physician
- San Antonio, TX
National Provider Identifier
1083721153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- K0101
- Practice address
- 701 S Zarzamora St
San Antonio, TX 78207-5209 - Phone
- (210) 358-7000
- Fax
- (210) 358-7406
- NPI assigned
- Aug 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | K0101 | TX | Primary |
Addresses
Primary practice location
701 S Zarzamora St
San Antonio, TX 78207-5209
Mailing address
PO Box 87
San Antonio, TX 78291-0087
Phone (210) 358-9172
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104492702 | Medicaid | TX |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| K0101 | TX | MD | Endocrinology, Diabetes & Metabolism Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Medicine Associates | Current | Accepting new patients | |
| Pain Management Specialists | Past | Accepting new patients |
Locations
701 S Zarzamora St
San Antonio, TX 78207
Phone (210) 358-7000
903 W Martin St
#492
San Antonio, TX 78207
Phone (210) 358-3441
Organizations & group practices 2
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.
-
- Family Medicine Physician
- San Antonio, TX
- NPI 1245313329
-
- Interventional Pain Medicine Physician
- San Antonio, TX
- NPI 1922617125
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": "1413417600000",
"number": "1083721153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 87",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782910087",
"telephone_number": "210-358-9172",
"fax_number": "210-358-9183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 S ZARZAMORA ST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782075209",
"telephone_number": "210-358-7000",
"fax_number": "210-358-7406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACIVITA",
"first_name": "KATHY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-24",
"last_updated": "2014-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "TX",
"license": "K0101",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104492702",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.