Individual provider Active NPI

Christopher David Pomelow, PA

  • Medical Physician Assistant
  • San Antonio, TX
National Provider Identifier
1144292715
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA05109 Issued in TX
Practice address
4438 Centerview
San Antonio, TX 78228-1440
Phone
(210) 280-0040
Fax
(210) 280-0060
NPI assigned
Feb 7, 2006
Last updated
Nov 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA05109 TX Primary

Addresses

Primary practice location

4438 Centerview
San Antonio, TX 78228-1440

Mailing address

4438 Centerview
San Antonio, TX 78228-1440
Phone (210) 280-0040

Other identifiers 2

IdentifierTypeStateIssuer
TXB157017OtherTXWELLMED MEDICARE
318808801OtherTXWELLMED MEDICAID

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
I20060705000088 TX Practitioner - Physician Assistant 8527070887 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA CurrentSince Feb 20, 2006 Accepting new patients
Wellmed Medical Group, P.a. CurrentSince Feb 20, 2006 Accepting new patients

Locations

1831 S General McMullen Dr
San Antonio, TX 78226
Phone (210) 434-1400

4438 Centerview
San Antonio, TX 78228
Phone (210) 280-0040

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

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1144292715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4438 CENTERVIEW",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281440",
            "telephone_number": "210-280-0040",
            "fax_number": "210-280-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4438 CENTERVIEW",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782281440",
            "telephone_number": "210-280-0040",
            "fax_number": "210-280-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POMELOW",
        "first_name": "CHRISTOPHER",
        "middle_name": "DAVID",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA05109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED MEDICARE",
            "identifier": "TXB157017",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED MEDICAID",
            "identifier": "318808801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.