Individual provider Active NPI

Alexis Renee Wahlen, APRN-CNP

  • Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1194303784
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1017381 Issued in TX
Practice address
4499 Medical Dr Ste 166
San Antonio, TX 78229-3771
Phone
(210) 575-8485
NPI assigned
Apr 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1017381 TX
Nurse Practitioner 363L00000X 1017381 TX Primary

Addresses

Primary practice location

4499 Medical Dr Ste 166
San Antonio, TX 78229-3771

Mailing address

7827 Caston Park Dr
San Antonio, TX 78249-4124
Phone (361) 944-4189

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
I20210505002336 TX Practitioner - Nurse Practitioner 8820407737 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
Group practices
Methodist Physician Practices PLLCGroup PAC ID 8022171974, 176 clinicians

Practice addresses (Care Compare)

4499 Medical Dr
Suite 166
San Antonio, TX 78229-3771
Phone (210) 575-8485

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.46 of 100Reported as group
Quality
71.92
Promoting interoperability
99
Improvement activities
40
Cost
71.86

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Physician Practices, PLLC CurrentSince May 1, 2021 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

111 Dallas St
Fl 4
San Antonio, TX 78205
Phone (210) 297-7195

4499 Medical Dr
Ste 166
San Antonio, TX 78229
Phone (210) 575-8485

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16700/brand/2/csg/1/fhir/r4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1194303784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7827 CASTON PARK DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782494124",
            "telephone_number": "361-944-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4499 MEDICAL DR STE 166",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293771",
            "telephone_number": "210-575-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHLEN",
        "first_name": "ALEXIS",
        "middle_name": "RENEE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-01",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1017381",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1017381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.