Individual provider Active NPI

Clarissa Myra Deleon, M.D.

  • Neonatal-Perinatal Medicine Physician
  • San Antonio, TX
National Provider Identifier
1225266729
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
P4154 Issued in TX
Practice address
5430 Fredericksburg Rd
Suite 508
San Antonio, TX 78229-3539
Phone
(210) 541-8281
Fax
(210) 541-9123
NPI assigned
Jun 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X P4154 TX
Pediatrics Physician 208000000X BP10035446 TX
Neonatal-Perinatal Medicine Physician 2080N0001X P4154 TX Primary

Addresses

Primary practice location

5430 Fredericksburg Rd
Suite 508
San Antonio, TX 78229-3539

Mailing address

5430 Fredericksburg Rd
Suite 508
San Antonio, TX 78229-3539
Phone (210) 541-8281

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
I20120918000724 TX Practitioner - Pediatric MedicinePractitioner - Other (Physician) 2264680131 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10035446TXMDPediatrics Physician
P4154TXMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrix Medical Group of Texas Billing, Inc. Pediatrics CurrentSince Sep 1, 2012 Accepting new patients
Utmb Faculty Group Practice Pediatrics CurrentSince Oct 10, 2013 Accepting new patients
Magella Medical Associates Billing, Inc. Neonatal-Perinatal Medicine CurrentSince Jul 18, 2016 Accepting new patients
VHS San Antonio Partners LLC Past Accepting new patients

Locations

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

551 Hill Country Dr
Kerrville, TX 78028
Phone (830) 257-5414

555 Creekside Xing
New Braunfels, TX 78130
Phone (830) 387-4660

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

3001 George Bush Hwy
Ste 250
Richardson, TX 75082
Phone (888) 822-2855

333 N Santa Rosa
San Antonio, TX 78207
Phone (210) 704-2190

7930 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 297-5000

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

520 Madison Oak Dr
San Antonio, TX 78258
Phone (210) 297-0412

5430 Fredericksburg Rd
Ste 508
San Antonio, TX 78229
Phone (210) 541-8281

3333 Research Plz
San Antonio, TX 78235
Phone (210) 297-3000

1310 McCullough Ave
San Antonio, TX 78212
Phone (210) 208-2200

1139 E Sonterra Blvd
San Antonio, TX 78258
Phone (210) 638-2000

5106 W Loop 1604 N
San Antonio, TX 78251
Phone (210) 575-0355

3011 W Loop 1604 N
San Antonio, TX 78251
Phone (726) 266-7081

Organizations & group practices 4

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": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1225266729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5430 FREDERICKSBURG RD",
            "address_2": "SUITE 508",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293539",
            "telephone_number": "210-541-8281",
            "fax_number": "210-541-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5430 FREDERICKSBURG RD",
            "address_2": "SUITE 508",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293539",
            "telephone_number": "210-541-8281",
            "fax_number": "210-541-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELEON",
        "first_name": "CLARISSA",
        "middle_name": "MYRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-24",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P4154",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "BP10035446",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TX",
            "license": "P4154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.