Individual provider Active NPI

Mary Anne C. Snyder, D.O.

  • Family Medicine Physician
  • Columbus, IN
National Provider Identifier
1275976573
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
Q8644 Issued in TX
Practice address
806 Jackson St
Columbus, IN 47201-6264
Phone
(812) 748-3412
Fax
(812) 748-3413
NPI assigned
Apr 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Q8644 TX Primary

Addresses

Primary practice location

806 Jackson St
Columbus, IN 47201-6264

Mailing address

1848 Lafayette Ave
Columbus, IN 47201-5121
Phone (812) 748-3412

Other names 1

  • Dr. Mary Anne C. Estacio 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190502000685 TX Practitioner - Family Practice 0840532396 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
BHS Physicians Network, Inc Family Medicine CurrentSince Feb 27, 2019 Accepting new patients
BHS Physicians Network, Inc CurrentSince Feb 27, 2019 Accepting new patients
Major Hospital Past Accepting new patients

Locations

143 W Sunset Rd
Ste 100
San Antonio, TX 78209
Phone (210) 545-3660

3903 Wiseman Blvd
San Antonio, TX 78251
Phone (210) 681-0126

Organizations & group practices 3

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": "1366156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1275976573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1848 LAFAYETTE AVE",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472015121",
            "telephone_number": "812-748-3412",
            "fax_number": "812-748-3413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 JACKSON ST",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472016264",
            "telephone_number": "812-748-3412",
            "fax_number": "812-748-3413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "MARY ANNE",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-17",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q8644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY ANNE",
            "last_name": "ESTACIO",
            "middle_name": "C.",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbus, IN

Sources for this page

Verify at the official NPI Registry.