Organization Active NPI

Westover Primary Care Clinic PLLC

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1184574014
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WESTOVER PRIMARY CARE CLINIC PLLC
Practice address
9022 Culebra Rd Ste 109
San Antonio, TX 78251-2886
Phone
(210) 802-3777
Fax
(210) 819-4555
NPI assigned
Jan 30, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Authorized official

Name
Stella Koretsky, M.D.NPI 1487841342
Title
Medical Director
Phone
(210) 802-3777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

9022 Culebra Rd Ste 109
San Antonio, TX 78251-2886

Mailing address

9022 Culebra Rd Ste 109
San Antonio, TX 78251-2886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260306000348 TX Part B Supplier - Clinic/Group Practice 0345722559 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2342203Westover Primary Care Clinic9022 Culebra Rd Ste 109, San Antonio, TX 78251Certificate of waiverApr 14, 2028

National Provider Directory

National Provider Directory

Locations

9022 Culebra Rd
Ste 109
San Antonio, TX 78251
Phone (210) 802-3777

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1769731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772064000000",
    "number": "1184574014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9022 CULEBRA RD STE 109",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782512886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9022 CULEBRA RD STE 109",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782512886",
            "telephone_number": "210-802-3777",
            "fax_number": "210-819-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTOVER PRIMARY CARE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-30",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A",
        "authorized_official_last_name": "KORETSKY",
        "authorized_official_first_name": "STELLA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "210-802-3777",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2026; 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.