Individual provider Active NPI

Rosemaria Gennuso, MD

  • Pediatric Surgery Physician
  • San Antonio, TX
National Provider Identifier
1093771297
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
M0411 Issued in TX
Practice address
4410 Medical Dr
Ste 540
San Antonio, TX 78229-6306
Phone
(210) 575-6240
Fax
(210) 575-6280
NPI assigned
Apr 25, 2006
Last updated
Jan 27, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X M0411 TX
Pediatrics Physician 208000000X M0411 TX
Surgical Critical Care Physician 2086S0102X M0411 TX
Pediatric Surgery Physician 2086S0120X M0411 TX Primary
Surgical Oncology Physician 2086X0206X M0411 TX

Addresses

Primary practice location

4410 Medical Dr
Ste 540
San Antonio, TX 78229-6306

Mailing address

8109 Fredericksburg Rd
Physician Practice Services
San Antonio, TX 78229-3311
Phone (210) 575-6240

Other identifiers 3

IdentifierTypeStateIssuer
178202106OtherTXCSHCN
178202105MedicaidTX
8BX390OtherBCBS TX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ROSEMARIA.GENNUSO@hca7.eclinicaldirectplus.com

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
I20050203000620 TX Practitioner - NeurosurgeryPractitioner - NeurologyPractitioner - Other (Physician)Practitioner - Pediatric Medicine 9335190636 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M0411TXMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Physician Practices, PLLC Neurological Surgery CurrentSince Sep 1, 2012 Accepting new patients
Methodist Healthcare System of San Antonio, LTD., L.L.P. Past Accepting new patients
Methodist Healthcare System of San Antonio, LTD., L.L.P. Past Accepting new patients
Texas Institute of Medicine and Surgery Neurological Surgery Past Accepting new patients
Texas Institute of Pediatrics PLLC Neurological Surgery Past Accepting new patients

Locations

111 Dallas St
Fl 4
San Antonio, TX 78205
Phone (210) 297-7195

4410 Medical Dr
Ste 540
San Antonio, TX 78229
Phone (210) 575-6240

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

7930 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 297-5000

8109 Fredericksburg Rd
San Antonio, TX 78229
Phone (210) 575-0355

8201 Ewing Halsell Dr
San Antonio, TX 78229
Phone (210) 575-4837

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16700/brand/2/csg/1/fhir/r4
  • Direct secure messaging: rosemaria.gennuso@hca7.eclinicaldirectplus.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1093771297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8109 FREDERICKSBURG RD",
            "address_2": "PHYSICIAN PRACTICE SERVICES",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293311",
            "telephone_number": "210-575-6240",
            "fax_number": "210-575-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 MEDICAL DR",
            "address_2": "STE 540",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782296306",
            "telephone_number": "210-575-6240",
            "fax_number": "210-575-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENNUSO",
        "first_name": "ROSEMARIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "M0411",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M0411",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "TX",
            "license": "M0411",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "TX",
            "license": "M0411",
            "primary": true
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "TX",
            "license": "M0411",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "178202106",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178202105",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "8BX390",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ROSEMARIA.GENNUSO@hca7.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "4410 Medical Dr",
            "address_2": "STE 540",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782296306",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.