NPIMap

Individual provider Active NPI

Siegfried Pueblitz, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Laredo, TX
National Provider Identifier
1316915119
Registry record updated Jan 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
J2746 Issued in TX
Practice address
1700 E Saunders St
Laredo, TX 78041-5474
Phone
(210) 617-4445
NPI assigned
Mar 9, 2006
Last updated
Jan 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X J2746 TX Primary
General Practice Physician 208D00000X J2746 TX

Addresses

Primary practice location

1700 E Saunders St
Laredo, TX 78041-5474

Mailing address

6918 Camp Bullis Rd
San Antonio, TX 78256-2236
Phone (210) 497-0445

Other identifiers 1

IdentifierTypeStateIssuer
131091408MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, PA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100824000541 TX Practitioner - Pathology 7517978851 Reassigns benefits to 2 organizations
I20180326002103 PA Practitioner - Pathology 7517978851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Corepath Laboratories, P.a.Group PAC ID 9032267323, 11 clinicians

Practice addresses (Care Compare)

1700 E Saunders St
Laredo Medical Center
Laredo, TX 78041-5474
Phone (210) 617-4445

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Corepath Laboratories, P.a. CurrentSince Aug 14, 2023 Accepting new patients
Corepath Laboratories, P.a. Anatomic Pathology & Clinical Pathology CurrentSince Aug 14, 2023 Accepting new patients
Laredo Physicians Group CurrentSince Feb 2, 2026 Accepting new patients
Corepath Laboratories, P.a. Current Accepting new patients
Western Pennsylvania Pathology, P.C. CurrentSince Feb 14, 2018 Accepting new patients
Windber Hospital, Inc. Current Accepting new patients
Laboratory Medicine Services PA Anatomic Pathology & Clinical Pathology CurrentSince Jul 11, 2002 Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Cardiovascular Care Providers, Inc. Past Accepting new patients
Northeast Texas Public Health District Past Accepting new patients
Medcore Associates, PLLC Anatomic Pathology & Clinical Pathology Past Accepting new patients
Medcore Associates, PLLC Anatomic Pathology & Clinical Pathology Past Accepting new patients

Locations

600 Somerset Ave
Windber, PA 15963
Phone (814) 467-3000

10700 McPherson Rd
Laredo, TX 78045
Phone (956) 523-2190

1700 E Saunders St
Laredo, TX 78041
Phone (956) 206-6971

6801 McPherson Rd
Laredo, TX 78041
Phone (956) 721-0200

Organizations & group practices 12

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 2

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": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1316915119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6918 CAMP BULLIS RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782562236",
            "telephone_number": "210-497-0445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E SAUNDERS ST",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780415474",
            "telephone_number": "210-617-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUEBLITZ",
        "first_name": "SIEGFRIED",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "J2746",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "J2746",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131091408",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.