Active NPI
Sanjay Nancherla, OD
- Optometrist
- San Antonio, TX
National Provider Identifier
1306369574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 9256TG
- Practice address
- 115 N Loop 1604 E Ste 1103
San Antonio, TX 78232-1399 - Phone
- (210) 635-0050
- NPI assigned
- Jul 19, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 9256TG | TX | Primary |
Addresses
Primary practice location
115 N Loop 1604 E Ste 1103
San Antonio, TX 78232-1399
Mailing address
115 N Loop 1604 E Ste 1103
San Antonio, TX 78232-1399
Phone (210) 364-2226
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171102002850 | TX | Practitioner - Optometry | 6103182472 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9256 | TX | MD | General Practice Dentistry |
| 9256TG | TX | MD | Optometrist |
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": "1500422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648771200000",
"number": "1306369574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 N LOOP 1604 E STE 1103",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782321399",
"telephone_number": "210-364-2226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 N LOOP 1604 E STE 1103",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782321399",
"telephone_number": "210-635-0050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NANCHERLA",
"first_name": "SANJAY",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-07-19",
"last_updated": "2022-04-01",
"certification_date": "2022-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "9256TG",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.