Individual provider Active NPI

Suzanne Wesley Rienstra, MD

  • Pediatrics Physician
  • San Antonio, TX
National Provider Identifier
1134410624
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
Q0304 Issued in TX
Practice address
14615 San Pedro Ave Ste 218-220
San Antonio, TX 78232-4321
Phone
(210) 644-3650
Fax
(210) 702-6979
NPI assigned
May 2, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Q0304 TX Primary
Pediatrics Physician 208000000X BP20047377 TX

Addresses

Primary practice location

14615 San Pedro Ave Ste 218-220
San Antonio, TX 78232-4321

Mailing address

903 W Martin St # Ms 49-2
San Antonio, TX 78207-0903
Phone (201) 358-5909

Other practice location 1

5282 Medical Dr Ste 240
San Antonio, TX 78229-4849
Phone (210) 358-8820

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address srientra28889@uhssa.direct-ci.com Direct

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
I20141201000093 TX Practitioner - Pediatric Medicine 0143542258 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP20047377TXMDPediatrics Physician
Q0304TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Management Specialists CurrentSince Jun 22, 2021 Accepting new patients
Community Medicine Associates Pediatrics CurrentSince Oct 1, 2014 Accepting new patients

Locations

903 W Martin St
#492
San Antonio, TX 78207
Phone (210) 358-3441

14615 San Pedro Ave
Ste 218
San Antonio, TX 78232
Phone (210) 495-4200

5282 Medical Dr
Ste 240
San Antonio, TX 78229
Phone (210) 358-8820

14615 San Pedro Ave
Ste 218220
San Antonio, TX 78232
Phone (210) 644-3050

903 W Martin St
San Antonio, TX 78207
Phone (210) 358-3400

Interoperability endpoints

  • Direct secure messaging: srientra28889@uhssa.direct-ci.com
  • Direct secure messaging: srienstra28889@uhssa.direct-ci.com

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": "1304294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1134410624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 W MARTIN ST # MS 49-2",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782070903",
            "telephone_number": "201-358-5909",
            "fax_number": "210-358-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14615 SAN PEDRO AVE STE 218-220",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782324321",
            "telephone_number": "210-644-3650",
            "fax_number": "210-702-6979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5282 Medical Dr Ste 240",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782294849",
            "country_code": "US",
            "telephone_number": "210-358-8820",
            "fax_number": "210-702-4340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIENSTRA",
        "first_name": "SUZANNE",
        "middle_name": "WESLEY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-02",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q0304",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "BP20047377",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "srientra28889@uhssa.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5282 Medical Dr Ste 240",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782294849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.