Individual provider Active NPI

David Cantu, PA-C

  • Physician Assistant
  • Edinburg, TX
National Provider Identifier
1205999448
Registry record updated May 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA04960 Issued in TX
Practice address
2402 Cornerstone Blvd
Edinburg, TX 78539-8462
Phone
(956) 668-0060
Fax
(956) 668-0070
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA04960 TX Primary

Addresses

Primary practice location

2402 Cornerstone Blvd
Edinburg, TX 78539-8462

Mailing address

2402 Cornerstone Blvd
Edinburg, TX 78539-8462
Phone (956) 668-0060

Other identifiers 1

IdentifierTypeStateIssuer
1205999448OtherTXNPI

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
I20100113000645 TX Practitioner - Physician Assistant 8325189228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Raul a. Marquez, MD PAGroup PAC ID 8123007887, 8 clinicians

Practice addresses (Care Compare)

2402 Cornerstone Blvd
Edinburg, TX 78539-8462
Phone (956) 668-0060

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA04960TXMDPhysician Assistant

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.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400544000000",
    "number": "1205999448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2402 CORNERSTONE BLVD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785398462",
            "telephone_number": "956-668-0060",
            "fax_number": "956-668-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 CORNERSTONE BLVD",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785398462",
            "telephone_number": "956-668-0060",
            "fax_number": "956-668-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTU",
        "first_name": "DAVID",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2014-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1205999448",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

Verify at the official NPI Registry.