Individual provider Active NPI

Nikki K Conlin, MD

  • Anesthesiology Physician
  • San Antonio, TX
National Provider Identifier
1093939795
Registry record updated Jun 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
P0897 Issued in TX
Practice address
4242 Medical Dr
Suite 3100
San Antonio, TX 78229-5640
Phone
(210) 615-1187
Fax
(210) 614-2180
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01060616A IN
Anesthesiology Physician 207L00000X P0897 TX Primary

Addresses

Primary practice location

4242 Medical Dr
Suite 3100
San Antonio, TX 78229-5640

Mailing address

PO Box 34717
San Antonio, TX 78265-4717
Phone (210) 615-1187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MD, SC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20141203000829 TX Practitioner - Anesthesiology 4082936935 Reassigns benefits to 1 organization
I20150803001747 MD Practitioner - Anesthesiology 4082936935 Reassigns benefits to 2 organizations
I20171004000402 SC Practitioner - Anesthesiology 4082936935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifebridge Anesthesia Associates LLCGroup PAC ID 2062514888, 109 clinicians

Practice addresses (Care Compare)

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone 80051653155104

Hospital & facility affiliations

  • Sinai Hospital of Baltimore Hospital, Baltimore, MD, CCN 210012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01060616AINMDAnesthesiology Physician
P0897TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tejas Anesthesia PLLC Anesthesiology CurrentSince Jun 23, 2014 Accepting new patients
Tejas Anesthesia PLLC Anesthesiology CurrentSince Jun 23, 2014 Accepting new patients
North American Partners in Anesthesia Maryland LLC Anesthesiology CurrentSince Jan 1, 2018 Accepting new patients
Lifebridge Anesthesia Associates, LLC Anesthesiology CurrentSince Jun 1, 2023 Accepting new patients
Beach Anesthesia, LLC Anesthesiology CurrentSince Jul 12, 2017 Accepting new patients

Locations

2401 W Belvedere Ave
Baltimore, MD 21215

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

109 Blarney Dr
Columbia, SC 29223
Phone (803) 865-8200

2240 Gulf Fwy S
League City, TX 77573
Phone (832) 505-1000

4242 Medical Dr
Ste 3100
San Antonio, TX 78229
Phone (210) 477-9555

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403049600000",
    "number": "1093939795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34717",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782654717",
            "telephone_number": "210-615-1187",
            "fax_number": "210-614-2180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4242 MEDICAL DR",
            "address_2": "SUITE 3100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295640",
            "telephone_number": "210-615-1187",
            "fax_number": "210-614-2180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLIN",
        "first_name": "NIKKI",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2014-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01060616A",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "P0897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.