Individual provider Active NPI

Amy Lynn Marin, CPNP-PC

  • Pediatric Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1124570262
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP132195 Issued in TX
Practice address
5430 Fredericksburg Rd Ste 508
San Antonio, TX 78229-3561
Phone
(210) 541-8281
Fax
(210) 541-9123
NPI assigned
Oct 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP132195 TX Primary

Addresses

Primary practice location

5430 Fredericksburg Rd Ste 508
San Antonio, TX 78229-3561

Mailing address

5430 Fredericksburg Rd
Suite 508
San Antonio, TX 78229-3539
Phone (210) 541-8281

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
I20250414001554 TX Practitioner - Nurse Practitioner 9133643968 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Magella Medical Associates Billing, Inc. CurrentSince Dec 13, 2024 Accepting new patients

Locations

4900 Mueller Blvd
Austin, TX 78723
Phone (512) 324-0165

815 Market St
Galveston, TX 77550
Phone (409) 770-6600

11777 FM 1960 Rd W
Houston, TX 77065
Phone (832) 828-3501

2700 W Pleasant Run Rd
Ste 220
Lancaster, TX 75146
Phone (888) 871-1883

600 N Union Ave
New Braunfels, TX 78130
Phone (830) 606-9111

10223 Broadway St
Ste E
Pearland, TX 77584
Phone (713) 340-2848

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

11212 State Highway 151
San Antonio, TX 78251
Phone (210) 281-5066

7930 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 297-5000

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

520 Madison Oak Dr
San Antonio, TX 78258
Phone (210) 297-0412

5430 Fredericksburg Rd
Ste 508
San Antonio, TX 78229
Phone (210) 541-8281

333 N Santa Rosa
San Antonio, TX 78207
Phone (210) 704-2190

3011 W Loop 1604 N
San Antonio, TX 78251
Phone (726) 266-7081

5106 W Loop 1604 N
San Antonio, TX 78251
Phone (210) 575-0355

3333 Research Plz
San Antonio, TX 78235
Phone (210) 297-3000

1310 McCullough Ave
San Antonio, TX 78212
Phone (210) 208-2200

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

1139 E Sonterra Blvd
San Antonio, TX 78258
Phone (210) 638-2000

421 E State Highway 114
Southlake, TX 76092
Phone (817) 865-4400

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": "1477267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1124570262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5430 FREDERICKSBURG RD",
            "address_2": "SUITE 508",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293539",
            "telephone_number": "210-541-8281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5430 FREDERICKSBURG RD STE 508",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293561",
            "telephone_number": "210-541-8281",
            "fax_number": "210-541-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIN",
        "first_name": "AMY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-24",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP132195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.