Individual provider Active NPI

Peter Jerome Torcivia

  • Psychiatric/Mental Health Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1154931723
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1034917 Issued in TX
Practice address
7122 Stonewall Hill
San Antonio, TX 78256
Phone
(210) 404-9696
Fax
(210) 404-9466
NPI assigned
Aug 7, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X UT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1034917 TX Primary

Addresses

Primary practice location

7122 Stonewall Hill
San Antonio, TX 78256

Mailing address

7122 Stonewall Hill
San Antonio, TX 78256
Phone (210) 404-9696

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
I20250121000317 TX Practitioner - Nurse Practitioner 8022547009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ep Ted Williams MD PAGroup PAC ID 2567990179, 10 clinicians

Practice addresses (Care Compare)

7122 Stonewall HL
San Antonio, TX 78256-1926
Phone (210) 404-9696

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1034917TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
E P Ted Williams Mdpa CurrentSince Oct 20, 2024 Accepting new patients

Locations

7122 Stonewall Hl
San Antonio, TX 78256
Phone (210) 404-9696

Organizations & group practices 1

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": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1154931723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7122 STONEWALL HILL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78256",
            "telephone_number": "210-404-9696",
            "fax_number": "210-404-9466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7122 STONEWALL HILL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78256",
            "telephone_number": "210-404-9696",
            "fax_number": "210-404-9466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORCIVIA",
        "first_name": "PETER",
        "middle_name": "JEROME",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-07",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "UT",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1034917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.