Organization Active NPI

Ples L Kujawa MD PA

  • Specialist
  • San Antonio, TX
National Provider Identifier
1134317118
Registry record updated Feb 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G5270 Issued in TX
Legal business name
PLES L KUJAWA MD PA
Practice address
12602 Toepperwein Road
Suite 202
San Antonio, TX 78233-3259
Phone
(210) 599-8110
Fax
(210) 257-0627
NPI assigned
Oct 4, 2007
Last updated
Feb 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2012

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

Authorized official

Name
Jeffrey Charles Webster
Title
Manager
Phone
(210) 599-8110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G5270 TX Primary

Addresses

Primary practice location

12602 Toepperwein Road
Suite 202
San Antonio, TX 78233-3259

Mailing address

12602 Toepperwein Road
Suite 202
San Antonio, TX 78233-3259
Phone (210) 599-8110

Other identifiers 1

IdentifierTypeStateIssuer
114144202MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040122000461 TX Part B Supplier - Clinic/Group Practice 5890697742 Receives reassigned benefits from 2 practitioners
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Locations

12602 Toepperwein Rd
Ste 202
Live Oak, TX 78233
Phone (210) 599-8110

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328832000000",
    "number": "1134317118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12602 TOEPPERWEIN ROAD",
            "address_2": "SUITE 202",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782333259",
            "telephone_number": "210-599-8110",
            "fax_number": "210-257-0627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12602 TOEPPERWEIN ROAD",
            "address_2": "SUITE 202",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782333259",
            "telephone_number": "210-599-8110",
            "fax_number": "210-257-0627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLES L KUJAWA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-04",
        "last_updated": "2012-02-10",
        "status": "A",
        "authorized_official_last_name": "WEBSTER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "210-599-8110"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "G5270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114144202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.