Organization Active NPI

San Antonio Diabetes and Endocrinology Consultants PLLC

  • Endocrinology, Diabetes & Metabolism Physician
  • San Antonio, TX
National Provider Identifier
1245677434
Registry record updated Jan 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
SAN ANTONIO DIABETES AND ENDOCRINOLOGY CONSULTANTS PLLC
Practice address
155 E Sonterra Blvd Ste 105
San Antonio, TX 78258-3988
Phone
(210) 314-8045
Fax
(210) 314-8073
NPI assigned
May 28, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2014

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

Authorized official

Name
Dr. Jaime Oscar Cruz, MDNPI 1396746442
Title
Member
Phone
(210) 314-8045

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

155 E Sonterra Blvd Ste 105
San Antonio, TX 78258-3988

Mailing address

155 E Sonterra Blvd Ste 105
San Antonio, TX 78258-3988
Phone (210) 314-8045

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131030001457 TX Part B Supplier - Clinic/Group Practice 7719112689 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1369699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389484800000",
    "number": "1245677434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 E SONTERRA BLVD STE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583988",
            "telephone_number": "210-314-8045",
            "fax_number": "210-314-8073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 E SONTERRA BLVD STE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583988",
            "telephone_number": "210-314-8045",
            "fax_number": "210-314-8073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANTONIO DIABETES AND ENDOCRINOLOGY CONSULTANTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-28",
        "last_updated": "2014-01-12",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "JAIME",
        "authorized_official_middle_name": "OSCAR",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "210-314-8045",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.