Organization Active NPI

PM&R Associates of San Antonio PLLC

  • Physical Medicine & Rehabilitation Physician
  • San Antonio, TX
National Provider Identifier
1245754357
Registry record updated Oct 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
P4538 Issued in TX
Legal business name
PM&R ASSOCIATES OF SAN ANTONIO PLLC
Practice address
17503 La Cantera Pkwy Ste 104-456
San Antonio, TX 78257-8207
Phone
(210) 571-7100
NPI assigned
Jul 31, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2019

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

Authorized official

Name
John Dennis Cayanan AlfonsoNPI 1558595660
Title
Manager
Phone
(210) 571-7100

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
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X P4538 TX Primary

Addresses

Primary practice location

17503 La Cantera Pkwy Ste 104-456
San Antonio, TX 78257-8207

Mailing address

17503 La Cantera Pkwy Ste 104-456
San Antonio, TX 78257-8207

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190725002520 TX Part B Supplier - Clinic/Group Practice 9133455330 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Locations

17503 La Cantera Pkwy
#104427
San Antonio, TX 78257
Phone (210) 621-8899

17503 La Cantera Pkwy
Ste 104456
San Antonio, TX 78257
Phone (210) 571-7100

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": "1501459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570579200000",
    "number": "1245754357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17503 LA CANTERA PKWY STE 104-456",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782578207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17503 LA CANTERA PKWY STE 104-456",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782578207",
            "telephone_number": "210-571-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PM&R ASSOCIATES OF SAN ANTONIO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-31",
        "last_updated": "2019-10-09",
        "status": "A",
        "authorized_official_last_name": "ALFONSO",
        "authorized_official_first_name": "JOHN DENNIS",
        "authorized_official_middle_name": "CAYANAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "210-571-7100"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "P4538",
            "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 Oct 9, 2019; 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.