Individual provider Active NPI

Michael Santos Valdez, P.A.

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1144431636
Registry record updated Aug 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00794 Issued in TX
Practice address
2425 Babcock Rd Ste 108
San Antonio, TX 78229-4899
Phone
(210) 616-9400
Fax
(210) 616-9402
NPI assigned
May 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA00794 TX Primary

Addresses

Primary practice location

2425 Babcock Rd Ste 108
San Antonio, TX 78229-4899

Mailing address

2425 Babcock Rd Ste 108
San Antonio, TX 78229-4899
Phone (210) 616-9400

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
I20110706000202 TX Practitioner - Physician Assistant 1658559166 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA00794TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Pain Consultants, PLLC CurrentSince Aug 20, 2012 Accepting new patients
Athens Family Medicine LLC PastSince Sep 8, 2025 Accepting new patients
Larina V Gutenberg DO PLLC PastSince Dec 6, 2011 Accepting new patients

Locations

5522 Lone Star Pkwy
Bldg 2
San Antonio, TX 78253
Phone (210) 298-4900

2425 Babcock Rd
Ste 108
San Antonio, TX 78229
Phone (210) 298-9004

Organizations & group practices 4

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": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343952000000",
    "number": "1144431636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 BABCOCK RD STE 108",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294899",
            "telephone_number": "210-616-9400",
            "fax_number": "210-616-9402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 BABCOCK RD STE 108",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294899",
            "telephone_number": "210-616-9400",
            "fax_number": "210-616-9402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDEZ",
        "first_name": "MICHAEL",
        "middle_name": "SANTOS",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2012-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA00794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.