Individual provider Active NPI

Tomas Coronado, M.D.

  • Ophthalmology Physician
  • San Antonio, TX
National Provider Identifier
1184669830
Registry record updated Jun 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
F6541 Issued in TX
Practice address
730 N Main
Suite 719
San Antonio, TX 78205-1152
Phone
(210) 271-0818
NPI assigned
Jun 17, 2006
Last updated
Jun 3, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X F6541 TX Primary

Addresses

Primary practice location

730 N Main
Suite 719
San Antonio, TX 78205-1152

Mailing address

730 N Main
Suite 719
San Antonio, TX 78205-1152
Phone (210) 271-0818

Other identifiers 5

IdentifierTypeStateIssuer
000000QL64OtherTXBLUE CROSS/BLUE SHIELD
120097402MedicaidTX
4059998OtherAETNA
742447517OtherTRICARE
17424475170001OtherTXSTATE OF TEXAS

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
I20100806000438 TX Practitioner - Ophthalmology 7719010073 Practice locations: San Antonio, TX

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Texas Medical School at San Antonio, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

730 N Main
Suite 719
San Antonio, TX 78205-1117
Phone (210) 271-0818

730 N Main Ave
San Antonio, TX 78205-1117

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F6541TXMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tomas Coronado MD CurrentSince Sep 1, 1986 Accepting new patients

Locations

730 N Main Ave
Ste 719
San Antonio, TX 78205
Phone (210) 271-0818

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401753600000",
    "number": "1184669830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 N MAIN",
            "address_2": "SUITE 719",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782051152",
            "telephone_number": "210-271-0818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 N MAIN",
            "address_2": "SUITE 719",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782051152",
            "telephone_number": "210-271-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORONADO",
        "first_name": "TOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2014-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "F6541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "000000QL64",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120097402",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4059998",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "742447517",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF TEXAS",
            "identifier": "17424475170001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.