Individual provider Active NPI

Elizabeth Ann Quan

  • Clinical Social Worker
  • San Antonio, TX
National Provider Identifier
1295308187
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
66076 Issued in TX
Practice address
9500 Tioga Dr Ste a
San Antonio, TX 78230-3118
Phone
(210) 616-0828
Fax
(855) 616-0829
NPI assigned
Jul 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 66076 TX Primary

Addresses

Primary practice location

9500 Tioga Dr Ste a
San Antonio, TX 78230-3118

Mailing address

9500 Tioga Dr Ste a
San Antonio, TX 78230-3118
Phone (210) 616-0828

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210803001692 TX Practitioner - Clinical Social Worker 9335543057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nueva Vida Behavioral Health Associates, IncGroup PAC ID 1052540176, 35 clinicians

Practice addresses (Care Compare)

9500 Tioga Dr
Suite a
San Antonio, TX 78230-3118
Phone (210) 616-0828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
66076TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Nueva Vida Behavioral Health Associates,Inc CurrentSince Jul 21, 2021 Accepting new patients

Locations

9500 Tioga Dr
Ste A
San Antonio, TX 78230
Phone (210) 616-0828

328 W Houston St
San Antonio, TX 78205
Phone (210) 225-3764

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": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1295308187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 TIOGA DR STE A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782303118",
            "telephone_number": "210-616-0828",
            "fax_number": "855-616-0829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 TIOGA DR STE A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782303118",
            "telephone_number": "210-616-0828",
            "fax_number": "855-616-0829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAN",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "66076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.