Organization Active NPI

Forensic Associates of San Antonio, PA

  • Clinical Psychologist
  • San Antonio, TX
National Provider Identifier
1194806174
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
30785 Issued in TX
Legal business name
FORENSIC ASSOCIATES OF SAN ANTONIO, PA
Practice address
16500 San Pedro Ave Ste 215
San Antonio, TX 78232-2253
Phone
(210) 403-2050
Fax
(210) 403-9890
NPI assigned
Oct 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Authorized official

Name
Susan Kraft
Title
Office Manager
Phone
(210) 403-2050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 30785 TX Primary

Addresses

Primary practice location

16500 San Pedro Ave Ste 215
San Antonio, TX 78232-2253

Mailing address

16500 San Pedro Ave Ste 215
San Antonio, TX 78232-2253
Phone (210) 403-2050

Other identifiers 2

IdentifierTypeStateIssuer
00082XMedicaidTX
175075401MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040805001692 TX Part B Supplier - Clinic/Group Practice 0648241133 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Locations

16500 San Pedro Ave
Ste 215
San Antonio, TX 78232
Phone (210) 403-2050

17020 San Pedro Ave
Ste 100
San Antonio, TX 78232
Phone (210) 403-2050

12915 Jones Maltsberger Rd
Ste 600
San Antonio, TX 78247
Phone (210) 403-2050

Practitioners & affiliated clinicians

Practitioners 8

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": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698969600000",
    "number": "1194806174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16500 SAN PEDRO AVE STE 215",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782322253",
            "telephone_number": "210-403-2050",
            "fax_number": "210-403-9890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16500 SAN PEDRO AVE STE 215",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782322253",
            "telephone_number": "210-403-2050",
            "fax_number": "210-403-9890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORENSIC ASSOCIATES OF SAN ANTONIO, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A",
        "authorized_official_last_name": "KRAFT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "210-403-2050"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "30785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00082X",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175075401",
            "state": "TX"
        }
    ],
    "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 Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.