Individual provider Active NPI

Maritza Pantoja

  • Internal Medicine Physician
  • Birmingham, AL
National Provider Identifier
1306370374
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
T4024 Issued in TX
Practice address
625 19TH St S
Birmingham, AL 35233-1900
Phone
(205) 934-9666
NPI assigned
Apr 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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 T4024 TX Primary

Addresses

Primary practice location

625 19TH St S
Birmingham, AL 35233-1900

Mailing address

625 19TH St S
Birmingham, AL 35233-1900

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
I20220823002076 TX Practitioner - Internal Medicine 8022491117 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical School at San Antonio, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usacs Integrated Acute Care Services of Texas, PLLCGroup PAC ID 7618237264, 398 clinicians

Practice addresses (Care Compare)

1201 W 38TH St
Austin, TX 78705-1006
Phone (512) 324-1000

260 Cully Dr
Kerrville, TX 78028-5950
Phone (830) 258-7747

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75.55 of 100Reported as group
Quality
70.56
Improvement activities
40
Cost
72.48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T4024TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usacs Integrated Acute Care Services of Texas, PLLC Internal Medicine CurrentSince Sep 26, 2024 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Internal Medicine CurrentSince Jun 1, 2022 Accepting new patients
Cogent Healthcare of Texas, PA Internal Medicine CurrentSince Jun 1, 2022 Accepting new patients
Ascension Seton Past Accepting new patients

Locations

601 E 15th St
Austin, TX 78701
Phone (512) 324-7868

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

3501 Mills Ave
Austin, TX 78731
Phone (512) 324-1017

1201 W 38th St
Austin, TX 78705
Phone (512) 324-1058

1401 Medical Pkwy
Cedar Park, TX 78613
Phone (512) 528-7000

3201 W State Highway 22
Corsicana, TX 75110
Phone (903) 654-6800

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

260 Cully Dr
Kerrville, TX 78028
Phone (830) 258-7323

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

201 Seton Pkwy
Round Rock, TX 78665
Phone (512) 324-1010

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1306370374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331900",
            "telephone_number": "205-934-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTOJA",
        "first_name": "MARITZA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T4024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.