NPIMap

Individual provider Active NPI

Michelle C Scanlan, MD

  • Internal Medicine Physician
  • San Antonio, TX
National Provider Identifier
1275534109
Registry record updated Jan 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K3936 Issued in TX
Practice address
4410 Medical Dr
Ste 100
San Antonio, TX 78229-6306
Phone
(210) 614-4000
Fax
(210) 614-9114
NPI assigned
Aug 2, 2005
Last updated
Jan 23, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X K3936 TX Primary

Addresses

Primary practice location

4410 Medical Dr
Ste 100
San Antonio, TX 78229-6306

Mailing address

4410 Medical Dr
Ste 100
San Antonio, TX 78229-6306
Phone (210) 614-4000

Other identifiers 2

IdentifierTypeStateIssuer
046653401MedicaidTX
110231816OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100427000309 TX Practitioner - Internal Medicine 1557498391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical School at Houston, 1995
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Pasteur Medical Associates PAGroup PAC ID 2769487701, 7 clinicians

Practice addresses (Care Compare)

4410 Medical Dr
Suite 100
San Antonio, TX 78229-3737
Phone (210) 614-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.37 of 100Reported as individual
Quality
96.65
Improvement activities
40
Cost
72.37

National Provider Directory

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JGHHBA/Endpoint/JGHHBA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232668800000",
    "number": "1275534109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 MEDICAL DR",
            "address_2": "STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782296306",
            "telephone_number": "210-614-4000",
            "fax_number": "210-614-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 MEDICAL DR",
            "address_2": "STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782296306",
            "telephone_number": "210-614-4000",
            "fax_number": "210-614-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANLAN",
        "first_name": "MICHELLE",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2009-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K3936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046653401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110231816",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.