Individual provider Active NPI

Christine Regina Erevelles, MD

  • Emergency Medicine Physician
  • San Antonio, TX
National Provider Identifier
1154356178
Registry record updated Jul 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD047572L Issued in PA
Practice address
15900 La Cantera Pkwy
Suite 20256
San Antonio, TX 78256-2422
Phone
(210) 314-4740
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD047572L PA Primary

Addresses

Primary practice location

15900 La Cantera Pkwy
Suite 20256
San Antonio, TX 78256-2422

Mailing address

15900 La Canter Parkway
Suite 15900 Level 5 Healthcare
San Antonio, TX 78256
Phone (210) 314-4740

Other identifiers 1

IdentifierTypeStateIssuer
001304314MedicaidPA

Other names 1

  • Christine Regina Tullius Former name

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
I20100107000471 TX Practitioner - Emergency Medicine 9335189620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.86 of 100Reported as group
Quality
92.78
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Third Coast Emergency Physicians Southwest PA Emergency Medicine CurrentSince Dec 1, 2019 Accepting new patients
Greater San Antonio Emergency Physicians, PA Emergency Medicine Past Accepting new patients
River City Emergency Physicians, PLLC Emergency Medicine Past Accepting new patients
Emergency Physicians of Pittsburgh, LTD Past Accepting new patients
Leading Edge Emergency Physicians, Inc Emergency Medicine Past Accepting new patients

Locations

100 Medical Pkwy
Lakeway, TX 78738
Phone (512) 206-8100

10811 Town Center Dr
San Antonio, TX 78251
Phone (210) 572-0911

7719 S Ih 35
San Antonio, TX 78224
Phone (210) 572-2955

16088 San Pedro Ave
San Antonio, TX 78232
Phone (210) 402-4092

4103 N Loop 1604 W
San Antonio, TX 78249
Phone (210) 572-8415

Organizations & group practices 5

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311292800000",
    "number": "1154356178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15900 LA CANTER PARKWAY",
            "address_2": "SUITE 15900 LEVEL 5 HEALTHCARE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78256",
            "telephone_number": "210-314-4740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15900 LA CANTERA PKWY",
            "address_2": "SUITE 20256",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782562422",
            "telephone_number": "210-314-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EREVELLES",
        "first_name": "CHRISTINE",
        "middle_name": "REGINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2011-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD047572L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001304314",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "TULLIUS",
            "middle_name": "REGINA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.