Individual provider Active NPI

Jeremy Nyle Wiersig, MD

  • Diagnostic Radiology Physician
  • San Antonio, TX
National Provider Identifier
1225096969
Registry record updated Mar 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
H5500 Issued in TX
Practice address
18802 Meisner Dr
San Antonio, TX 78258
Phone
(210) 572-2222
Fax
(210) 249-2177
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X H5500 TX Primary

Addresses

Primary practice location

18802 Meisner Dr
San Antonio, TX 78258

Mailing address

PO Box 1888
Greenville, TX 75403
Phone (800) 945-2455

Other identifiers 1

IdentifierTypeStateIssuer
136889611MedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040605000202 TX Practitioner - Diagnostic Radiology 7911989686 Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
H5500TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Imaging Diagnostic Radiology Current Accepting new patients
Concord Imaging at the Quarry, PA Diagnostic Radiology CurrentSince Aug 1, 2008 Accepting new patients
Btdi JV, LLP CurrentSince Feb 11, 2019 Accepting new patients
Btdi JV, LLP CurrentSince Apr 1, 2023 Accepting new patients
Btdi JV, LLP CurrentSince Jul 1, 2024 Accepting new patients
Btdi JV, LLP CurrentSince Dec 1, 2023 Accepting new patients
Btdi JV, LLP CurrentSince Aug 1, 2024 Accepting new patients
Acd-Sa, LTD. Past Accepting new patients
M&S Radiology Associates, PA Past Accepting new patients
Acd-Sa, LTD. PastSince Apr 30, 2003 Accepting new patients

Locations

18802 Meisner Dr
San Antonio, TX 78258
Phone (210) 572-2222

7220 Louis Pasteur Dr
Ste 115
San Antonio, TX 78229
Phone (210) 614-8899

423 Treeline Park
Ste 100
San Antonio, TX 78209
Phone (210) 704-0000

Organizations & group practices 10

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331510400000",
    "number": "1225096969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1888",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "75403",
            "telephone_number": "800-945-2455",
            "fax_number": "903-453-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18802 MEISNER DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78258",
            "telephone_number": "210-572-2222",
            "fax_number": "210-249-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIERSIG",
        "first_name": "JEREMY",
        "middle_name": "NYLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2012-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "H5500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136889611",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.