Individual provider Active NPI

Jordan Enid Hollsten, M.D.

  • Ophthalmology Physician
  • San Antonio, TX
National Provider Identifier
1316270069
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
P5535 Issued in TX
Practice address
4114 Pond Hill Rd Ste 100
San Antonio, TX 78231-1273
Phone
(210) 616-0739
Fax
(210) 616-0972
NPI assigned
Sep 14, 2009
Last updated
Jan 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X P5535 TX Primary
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X P5535 TX

Addresses

Primary practice location

4114 Pond Hill Rd Ste 100
San Antonio, TX 78231-1273

Mailing address

4114 Pond Hill Rd Ste 100
San Antonio, TX 78231-1273
Phone (210) 616-0739

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
I20130718000218 TX Practitioner - OphthalmologyPractitioner - Plastic and Reconstructive Surgery 1254572159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OphthalmologyAlso: Plastic and Reconstructive Surgery
Education
University of Texas Medical School at San Antonio, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4114 Pond Hill Rd
Suite 100
San Antonio, TX 78231-1273
Phone (210) 616-0739

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
50 of 100Reported as group
Quality
0
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Donald a Hollsten MD PLLC Ophthalmology CurrentSince Jul 1, 2016 Accepting new patients
Donald a. Hollsten, M.D. Ophthalmology Past Accepting new patients

Locations

4114 Pond Hill Rd
Ste 100
San Antonio, TX 78231
Phone (210) 616-0739

7950 Floyd Curl Dr
Ste 702
San Antonio, TX 78229
Phone (210) 614-1020

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1252886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1316270069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4114 POND HILL RD STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782311273",
            "telephone_number": "210-616-0739",
            "fax_number": "210-616-0972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4114 POND HILL RD STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782311273",
            "telephone_number": "210-616-0739",
            "fax_number": "210-616-0972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLSTEN",
        "first_name": "JORDAN",
        "middle_name": "ENID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-14",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "P5535",
            "primary": true
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "P5535",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.