Individual provider Active NPI

Marcus Rene Ayala, PA-C

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1134875669
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA15396 Issued in TX
Practice address
11212 Highway 151 Ste 100
San Antonio, TX 78251-4500
Phone
(210) 450-9900
Fax
(210) 450-9901
NPI assigned
Feb 23, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA8639 MA
Physician Assistant 363A00000X PA15396 TX Primary

Addresses

Primary practice location

11212 Highway 151 Ste 100
San Antonio, TX 78251-4500

Mailing address

11212 Highway 151 Ste 100
San Antonio, TX 78251-4500
Phone (210) 450-9900

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
I20230621003607 TX Practitioner - Physician Assistant 9133595952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Texas Health Science Center at San AntonioGroup PAC ID 0042128548, 1,290 clinicians

Practice addresses (Care Compare)

11071 Hwy 151
San Antonio, TX 78251-4844
Phone (210) 450-9000

7703 Floyd Curl Dr
San Antonio, TX 78229-3901
Phone (210) 450-9000

Hospital & facility affiliations

  • Ut Health San Antonio Multispecialty & Research Ho Hospital, San Antonio, TX, CCN 670335

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA8639MAMDPhysician Assistant
PA15396TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Health Science Center at San Antonio CurrentSince Jul 1, 2023 Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Jul 1, 2023 Accepting new patients

Locations

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

11212 State Highway 151
Ste 100
San Antonio, TX 78251
Phone (210) 450-9900

11071 State Highway 151
Ste 101
San Antonio, TX 78251
Phone (210) 450-9900

Interoperability endpoints

  • Direct secure messaging: mayala39689@direct.utmsa.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.

Hospital & facility affiliations 1

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": "1645574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1134875669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11212 HIGHWAY 151 STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782514500",
            "telephone_number": "210-450-9900",
            "fax_number": "210-450-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11212 HIGHWAY 151 STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782514500",
            "telephone_number": "210-450-9900",
            "fax_number": "210-450-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYALA",
        "first_name": "MARCUS",
        "middle_name": "RENE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-23",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA8639",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA15396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.