Clinica Familiar San Jose, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

TA03917 Issued in TX

Legal business name

CLINICA FAMILIAR SAN JOSE, PA

Practice address

8030 N FM 1015 Ste B
Mercedes, TX 78570-4809

Phone

(956) 825-9757

Fax

(956) 825-9125

NPI assigned

Oct 18, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Judy L Kutugata, RN

Title

Business Manager

Phone

(956) 969-2904

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jorge Luis Kutugata, M.D.

  • Pediatrics Physician
  • Weslaco, TX
  • NPI 1285748996
  Medicare reassignment

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374019200000",
    "number": "1174604763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8030 FM 1015 STE B",
            "city": "MERCEDES",
            "state": "TX",
            "postal_code": "785704809",
            "telephone_number": "956-825-9757",
            "fax_number": "956-825-9125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8030 N FM 1015 STE B",
            "city": "MERCEDES",
            "state": "TX",
            "postal_code": "785704809",
            "telephone_number": "956-825-9757",
            "fax_number": "956-825-9125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA FAMILIAR SAN JOSE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2013-07-17",
        "status": "A",
        "authorized_official_last_name": "KUTUGATA",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "956-969-2904",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "TA03917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALLEY HEALTH PLANS",
            "identifier": "117223100",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF TEXAS",
            "identifier": "8U4260",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176879802",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176879801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ariel Jacklyn Champion, PHARM.D.
• Amber Renee Chavez, OTR/L
• Cheers Therapy Center, LLC
• Melissa Marie Cisneros, SLP-A
• City of Mercedes
• CNF Enterprices Inc (Santa)
• CNF Enterprises, Inc. (Santa Helena Adult Day Care)
• Coach's RX Inc (Coach's Pharmacy)
• Coach's RX Inc (Coach's Pharmacy)
• Monica Colunga

• Family Medicine Physician in Mercedes, TX
• Providers in Mercedes, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.