Individual provider Active NPI

Sarah Ann Nishimuta, AGACNP

  • Acute Care Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1215647409
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1099693 Issued in TX
Practice address
5460 Babcock Rd # 120C
San Antonio, TX 78240-3901
Phone
(210) 753-0744
NPI assigned
Nov 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1099693 TX Primary

Addresses

Primary practice location

5460 Babcock Rd # 120C
San Antonio, TX 78240-3901

Mailing address

10231 Bull Run St
San Antonio, TX 78230-3229
Phone (760) 650-6988

Other identifiers 1

IdentifierTypeStateIssuer
1099693OtherTXTEXAS BOARD OF NURSING

Other names 1

  • Sarah Olmos Former name

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
I20230131003577 TX Practitioner - Nurse Practitioner 1850762782 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Health Science Center at San Antonio CurrentSince Feb 1, 2023 Accepting new patients
Wellmed Networks, Inc. CurrentSince Sep 4, 2024 Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Feb 1, 2023 Accepting new patients

Locations

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

4330 Medical Dr
Ste 500
San Antonio, TX 78229
Phone (210) 558-0122

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

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

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": "1669680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1215647409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10231 BULL RUN ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782303229",
            "telephone_number": "760-650-6988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5460 BABCOCK RD # 120C",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782403901",
            "telephone_number": "210-753-0744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISHIMUTA",
        "first_name": "SARAH",
        "middle_name": "ANN",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-29",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1099693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF NURSING",
            "identifier": "1099693",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "OLMOS",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.