Individual provider Active NPI

Hayley Dolan Buratowski, PA

  • Medical Physician Assistant
  • San Antonio, TX
National Provider Identifier
1093475402
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
12730 W Ih 10 Ste 306
San Antonio, TX 78230-1004
Phone
(210) 877-0772
NPI assigned
Dec 27, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X Primary

Addresses

Primary practice location

12730 W Ih 10 Ste 306
San Antonio, TX 78230-1004

Mailing address

21843 Ruby Run
San Antonio, TX 78259-2763

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220610001206 TX Practitioner - Physician Assistant 2860870466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Healthnet Medical Clinic LTDGroup PAC ID 1254354590, 11 clinicians

Practice addresses (Care Compare)

12730 W Ih
10 Suite 306
San Antonio, TX 78230-1004
Phone (210) 877-0772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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": "1640563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1093475402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21843 RUBY RUN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782592763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12730 W IH 10 STE 306",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301004",
            "telephone_number": "210-877-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURATOWSKI",
        "first_name": "HAYLEY",
        "middle_name": "DOLAN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-27",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.