Individual provider Active NPI

Ricardo J Requenez, NP

  • Family Nurse Practitioner
  • Alice, TX
National Provider Identifier
1215459565
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP134359 Issued in TX
Practice address
2510 E Main St Ste 102
Alice, TX 78332-4188
Phone
(361) 664-4445
Fax
(361) 664-4449
NPI assigned
Jul 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP134359 TX Primary

Addresses

Primary practice location

2510 E Main St Ste 102
Alice, TX 78332-4188

Mailing address

2510 E Main St Ste 102
Alice, TX 78332-4188
Phone (361) 664-4445

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
I20191113000856 TX Practitioner - Nurse Practitioner 1153753157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

6157 NW Loop 410
124 Wellmed at Ingram Park
San Antonio, TX 78238-3302
Phone (210) 523-1411

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, P.a. CurrentSince May 1, 2021 Accepting new patients
Wellmed Medical Group, P.a. CurrentSince May 1, 2021 Accepting new patients
Wellmed Medical Group, PA Current Accepting new patients

Locations

2510 E Main St
Ste 102
Alice, TX 78332
Phone (361) 664-4445

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

Interoperability endpoints

  • Direct secure messaging: ricardo.requenez@wellmed.eclinicaldirectplus.com

Organizations & group practices 3

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": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1215459565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2510 E MAIN ST STE 102",
            "city": "ALICE",
            "state": "TX",
            "postal_code": "783324188",
            "telephone_number": "361-664-4445",
            "fax_number": "361-664-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 E MAIN ST STE 102",
            "city": "ALICE",
            "state": "TX",
            "postal_code": "783324188",
            "telephone_number": "361-664-4445",
            "fax_number": "361-664-4449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REQUENEZ",
        "first_name": "RICARDO",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-07",
        "last_updated": "2022-07-21",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP134359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alice, TX

Sources for this page

Verify at the official NPI Registry.