Individual provider Active NPI

Jacob Ariel Garcia, APRN

  • Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1265068902
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP145147 Issued in TX
Practice address
4499 Medical Dr Ste 166
San Antonio, TX 78229-3771
Phone
(210) 575-8485
Fax
(210) 575-8499
NPI assigned
Mar 13, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP145147 TX
Gerontology Nurse Practitioner 363LG0600X AP145147 TX
Nurse Practitioner 363L00000X AP145147 TX Primary

Addresses

Primary practice location

4499 Medical Dr Ste 166
San Antonio, TX 78229-3771

Mailing address

4499 Medical Dr Ste 166
San Antonio, TX 78229-3771
Phone (210) 575-8485

Other names 1

  • Jacob Paredez 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
I20200924000271 TX Practitioner - Nurse Practitioner 0345669321 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP145147TXMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Ips LLC CurrentSince Sep 1, 2020 Accepting new patients

Locations

4458 Medical Dr
Ste 505
San Antonio, TX 78229

4499 Medical Dr
#150
San Antonio, TX 78229
Phone (210) 614-8181

4499 Medical Dr
Ste 166
San Antonio, TX 78229
Phone (210) 575-8485

1434 E Sonterra Blvd
Ste 210
San Antonio, TX 78258
Phone (210) 481-3119

Organizations & group practices 1

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": "1584057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1265068902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4499 MEDICAL DR STE 166",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293771",
            "telephone_number": "210-575-8485",
            "fax_number": "210-575-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4499 MEDICAL DR STE 166",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293771",
            "telephone_number": "210-575-8485",
            "fax_number": "210-575-8499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "JACOB",
        "middle_name": "ARIEL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-13",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP145147",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AP145147",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP145147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACOB",
            "last_name": "PAREDEZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.