Individual provider Active NPI

Jacob Lee Vosberg, DO

  • Internal Medicine Physician
  • San Antonio, TX
National Provider Identifier
1285213314
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
U0871 Issued in TX
Practice address
21 Spurs LN Ste 260
San Antonio, TX 78240-1671
Phone
(210) 615-8003
Fax
(210) 615-1141
NPI assigned
Apr 6, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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 U0871 TX Primary

Addresses

Primary practice location

21 Spurs LN Ste 260
San Antonio, TX 78240-1671

Mailing address

21 Spurs LN Ste 260
San Antonio, TX 78240-1671
Phone (210) 615-8003

Other practice location 1

903 SW 24th St
San Antonio, TX 78207-5136
Phone (210) 432-7801

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
I20240515002168 TX Practitioner - Internal Medicine 7517366826 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of the Incarnate Word School of Osteo Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spurs Lane Medical Associates PAGroup PAC ID 4587826268, 4 clinicians

Practice addresses (Care Compare)

21 Spurs LN
Suite 260
San Antonio, TX 78240-1671
Phone (210) 615-8003

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
U0871TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spurs Lane Medical Associates PA Internal Medicine CurrentSince Aug 1, 2024 Accepting new patients
Complete Care Medical Associates CurrentSince Aug 1, 2024 Accepting new patients

Locations

12446 West Ave
Ste 256
San Antonio, TX 78216

903 SW 24th St
San Antonio, TX 78207
Phone (210) 432-7801

12446 West Ave
Ste 200
San Antonio, TX 78216
Phone (210) 690-0230

21 Spurs Ln
Ste 260
San Antonio, TX 78240
Phone (210) 257-0705

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.

NPI Registry JSON

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

{
    "created_epoch": "1617667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1285213314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 SPURS LN STE 260",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401671",
            "telephone_number": "210-615-8003",
            "fax_number": "210-615-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SPURS LN STE 260",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401671",
            "telephone_number": "210-615-8003",
            "fax_number": "210-615-1141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "903 SW 24th St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782075136",
            "country_code": "US",
            "telephone_number": "210-432-7801",
            "fax_number": "210-432-7802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VOSBERG",
        "first_name": "JACOB",
        "middle_name": "LEE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-06",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "U0871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.