Individual provider Active NPI

Jose Mario Ayala, MD

  • Internal Medicine Physician
  • San Marcos, TX
National Provider Identifier
1114960663
Registry record updated Dec 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M5037 Issued in TX
Practice address
1301 Wonder World Dr
San Marcos, TX 78666-7533
Phone
(512) 353-8979
NPI assigned
Jun 13, 2006
Last updated
Dec 28, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M5037 TX Primary
Adolescent Medicine (Internal Medicine) Physician 207RA0000X 036104962 IL

Addresses

Primary practice location

1301 Wonder World Dr
San Marcos, TX 78666-7533

Mailing address

1301 Wonder World Dr
San Marcos, TX 78666-7533
Phone (512) 353-8979

Other identifiers 1

IdentifierTypeStateIssuer
8X6220OtherTXBCBS PROVIDER#

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
I20070306000067 TX Practitioner - HospitalistPractitioner - Pediatric MedicinePractitioner - Internal Medicine 9133222573 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine, Pediatric Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ipc Healthcare Services of Texas PLLCGroup PAC ID 3971824939, 184 clinicians

Practice addresses (Care Compare)

919 E 32ND St
Austin, TX 78705-2703
Phone (512) 544-4472

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M5037TXMDInternal Medicine Physician
036104962ILMDAdolescent Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Healthcare Services of Texas, PLLC Internal Medicine CurrentSince Mar 31, 2020 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Aug 15, 2018 Accepting new patients
Lonestar Pat Associates PA Internal Medicine CurrentSince Sep 29, 2020 Accepting new patients
Cogent Healthcare of Texas, PA Internal Medicine CurrentSince Feb 2, 2022 Accepting new patients
St. Davids Healthcare Partnership, L.P., LLP Past Accepting new patients
Planet Med LP Internal Medicine PastSince Apr 15, 2005 Accepting new patients

Locations

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 342-2382

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

2000 Scenic Dr
Georgetown, TX 78626
Phone (512) 863-2117

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

1301 Wonder World Dr
San Marcos, TX 78666
Phone (512) 353-8979

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1114960663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 WONDER WORLD DR",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667533",
            "telephone_number": "512-353-8979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 WONDER WORLD DR",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667533",
            "telephone_number": "512-353-8979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYALA",
        "first_name": "JOSE",
        "middle_name": "MARIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M5037",
            "primary": true
        },
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "IL",
            "license": "036104962",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER#",
            "identifier": "8X6220",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, TX

Sources for this page

Verify at the official NPI Registry.