Individual provider Active NPI

Amber Vigue Peterson, MPAS PAC

  • Physician Assistant
  • Bulverde, TX
National Provider Identifier
1124206875
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA05652 Issued in TX
Practice address
524 Singing Oaks Ste 200
Bulverde, TX 78070-6533
Phone
(830) 980-8433
Fax
(830) 980-8442
NPI assigned
Feb 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA05652 TX Primary

Addresses

Primary practice location

524 Singing Oaks Ste 200
Bulverde, TX 78070-6533

Mailing address

524 Singing Oaks Ste 200
Bulverde, TX 78070-6533
Phone (830) 980-8433

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
I20131014001001 TX Practitioner - Physician Assistant 3274767892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Texas Southwestern Medical School at Dallas, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

6157 NW Loop 410
124 Wellmed at Ingram Park
San Antonio, TX 78238-3302
Phone (210) 523-1411

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA CurrentSince Aug 1, 2013 Accepting new patients

Locations

524 Singing Oaks
Ste 200
Bulverde, TX 78070
Phone (830) 620-9429

2922 Morgan Ave
Corpus Christi, TX 78405
Phone (361) 887-6601

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

Interoperability endpoints

  • Direct secure messaging: amber.viguepeterson@wellmed.eclinicaldirectplus.com

Organizations & group practices 1

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": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1124206875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 SINGING OAKS STE 200",
            "city": "BULVERDE",
            "state": "TX",
            "postal_code": "780706533",
            "telephone_number": "830-980-8433",
            "fax_number": "830-980-8442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 SINGING OAKS STE 200",
            "city": "BULVERDE",
            "state": "TX",
            "postal_code": "780706533",
            "telephone_number": "830-980-8433",
            "fax_number": "830-980-8442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "AMBER",
        "middle_name": "VIGUE",
        "name_prefix": "Mrs.",
        "credential": "MPAS PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-05",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bulverde, TX

Sources for this page

Verify at the official NPI Registry.