Individual provider Active NPI

Steffany Lea Mock, PA-C

  • Medical Physician Assistant
  • San Antonio, TX
National Provider Identifier
1194996314
Registry record updated Jun 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA03206 Issued in TX
Practice address
19260 Stone Oak Pkwy
Suite 105
San Antonio, TX 78258-3365
Phone
(210) 402-3456
NPI assigned
Mar 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA03206 TX Primary

Addresses

Primary practice location

19260 Stone Oak Pkwy
Suite 105
San Antonio, TX 78258-3365

Mailing address

19260 Stone Oak Pkwy
Suite 105
San Antonio, TX 78258-3365
Phone (210) 402-3456

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
I20090303000490 TX Practitioner - Physician Assistant 4486710290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medcare Associates PAGroup PAC ID 5294714580, 28 clinicians

Practice addresses (Care Compare)

1051 US Hwy 90 E
Castroville, TX 78009-5210
Phone (830) 931-3336

120 Medical Dr
Boerne, TX 78006-1830
Phone (830) 816-5700

1434 E Sonterra Blvd
Suite 206
San Antonio, TX 78258-4973
Phone (210) 402-3456

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA03206TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medcare Associates PA Past Accepting new patients
Northeast Internal Medical Associates PLLC Past Accepting new patients
Frank C Kretsinger, D.O., PA Past Accepting new patients
BHS Specialty Network Inc Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243900800000",
    "number": "1194996314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19260 STONE OAK PKWY",
            "address_2": "SUITE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583365",
            "telephone_number": "210-402-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19260 STONE OAK PKWY",
            "address_2": "SUITE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583365",
            "telephone_number": "210-402-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOCK",
        "first_name": "STEFFANY",
        "middle_name": "LEA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-14",
        "last_updated": "2009-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA03206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.