Individual provider Active NPI

Terry Lee Emanuel, PA

  • Medical Physician Assistant
  • San Antonio, TX
National Provider Identifier
1093822082
Registry record updated Apr 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA02068 Issued in TX
Practice address
8606 Cheviot HTS
San Antonio, TX 78254-2302
Phone
(210) 393-7553
NPI assigned
Aug 24, 2006
Last updated
Apr 3, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA02068 TX Primary

Addresses

Primary practice location

8606 Cheviot HTS
San Antonio, TX 78254-2302

Mailing address

8606 Cheviot Heights
San Antonio, TX 78212
Phone (210) 393-7553

Other identifiers 1

IdentifierTypeStateIssuer
87N248OtherTXMEDICARE PIN FOR GROUP 00T148

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090504000311 TX Practitioner - Physician Assistant 5193873008 Reassigns benefits to 1 organization
I20241118001019 CO Practitioner - Physician Assistant 5193873008 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Health Science Center at San Antonio Past Accepting new patients
Riverwalk Clinic, LLC Past Accepting new patients

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428019200000",
    "number": "1093822082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8606 CHEVIOT HEIGHTS",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78212",
            "telephone_number": "210-393-7553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8606 CHEVIOT HTS",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782542302",
            "telephone_number": "210-393-7553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMANUEL",
        "first_name": "TERRY",
        "middle_name": "LEE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2015-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA02068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN FOR GROUP 00T148",
            "identifier": "87N248",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.