Individual provider Active NPI

Elijah Geesaman, PA-C

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1265178297
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19764 Issued in TX
Practice address
4411 Medical Dr Ste 210
San Antonio, TX 78229-3849
Phone
(210) 615-7700
Fax
(210) 615-1958
NPI assigned
May 11, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA19764 TX Primary

Addresses

Primary practice location

4411 Medical Dr Ste 210
San Antonio, TX 78229-3849

Mailing address

4411 Medical Dr Ste 210
San Antonio, TX 78229-3849
Phone (210) 615-7700

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
I20260129002779 TX Practitioner - Physician Assistant 2860970092 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiology Clinic of San Antonio, PLLCGroup PAC ID 1153517420, 125 clinicians

Practice addresses (Care Compare)

4411 Medical Dr
Suite 210
San Antonio, TX 78229-3849
Phone (210) 615-7700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA19764TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiology Clinic of San Antonio, PLLC CurrentSince Mar 1, 2026 Accepting new patients
San Antonio Cardiology Clinic PA Past Accepting new patients

Locations

4411 Medical Dr
Ste 300
San Antonio, TX 78229
Phone (210) 582-5145

4411 Medical Dr
Ste 210
San Antonio, TX 78229
Phone (210) 615-7700

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1265178297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 MEDICAL DR STE 210",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293849",
            "telephone_number": "210-615-7700",
            "fax_number": "210-615-1958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 MEDICAL DR STE 210",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293849",
            "telephone_number": "210-615-7700",
            "fax_number": "210-615-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEESAMAN",
        "first_name": "ELIJAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-11",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA19764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.