Individual provider Active NPI

Luis Moncada

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1104436617
Registry record updated Mar 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA15818 Issued in TX
Practice address
1150 N Loop 1604 W Ste 150
San Antonio, TX 78248-4505
Phone
(281) 783-8162
NPI assigned
Aug 10, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA15818 TX Primary

Addresses

Primary practice location

1150 N Loop 1604 W Ste 150
San Antonio, TX 78248-4505

Mailing address

5718 Westheimer Rd Ste 400
Houston, TX 77057-5733
Phone (281) 783-8162

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
I20220926002263 TX Practitioner - Physician Assistant 6608252838 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
Nluc PLLCGroup PAC ID 3072752302, 219 clinicians

Practice addresses (Care Compare)

1150 N Loop 1604
Suite 150
San Antonio, TX 78248-4505
Phone (281) 783-8162

1246 N FM 3083 Rd W
Suite B
Conroe, TX 77304-5340
Phone (281) 783-8162

16312 Southwest Fwy
Sugar Land, TX 77479-2371
Phone (281) 783-8162

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA15818TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Nluc PLLC CurrentSince Dec 10, 2022 Accepting new patients

Locations

1246 N FM 3083 Rd W
Ste B
Conroe, TX 77304

1150 N Loop 1604 W
Ste 150
San Antonio, TX 78248

5211 FM 2920 Rd
Ste 101
Spring, TX 77388

16312 Southwest Fwy
Ste 18
Sugar Land, TX 77479

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.

NPI Registry JSON

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1104436617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5718 WESTHEIMER RD STE 400",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770575733",
            "telephone_number": "281-783-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N LOOP 1604 W STE 150",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782484505",
            "telephone_number": "281-783-8162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONCADA",
        "first_name": "LUIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-08-10",
        "last_updated": "2023-03-10",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA15818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.