Individual provider Active NPI

Grace Mukamana, MD

  • Neurology Physician
  • San Antonio, TX
National Provider Identifier
1326256348
Registry record updated Jun 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
N3913 Issued in TX
Practice address
8715 Village Dr Ste 418
San Antonio, TX 78217-5407
Phone
(210) 655-3800
Fax
(210) 655-3801
NPI assigned
May 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X N3913 TX
Neurology Physician 2084N0400X N3913 TX Primary

Addresses

Primary practice location

8715 Village Dr Ste 418
San Antonio, TX 78217-5407

Mailing address

8711 Village Dr Ste 114
San Antonio, TX 78217-5419
Phone (210) 655-3800

Other identifiers 1

IdentifierTypeStateIssuer
210192501MedicaidTX

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
I20091125000611 TX Practitioner - NeurologyPractitioner - Psychiatry 1759420037 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Psychiatry
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BHS Physicians Network, IncGroup PAC ID 7315019593, 702 clinicians

Practice addresses (Care Compare)

8715 Village Dr
San Antonio, TX 78217-5407
Phone (210) 655-3800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N3913TXMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BHS Physicians Network, Inc CurrentSince Oct 15, 2018 Accepting new patients
BHS Physicians Network, Inc CurrentSince Oct 15, 2018 Accepting new patients
Ipc Healthcare Services of Texas, PLLC Neurology CurrentSince Jun 1, 2016 Accepting new patients
BHS Specialty Network Inc Past Accepting new patients

Locations

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

8715 Village Dr
Ste 418
San Antonio, TX 78217
Phone (210) 655-3800

8711 Village Dr
Ste 114
San Antonio, TX 78217
Phone (210) 297-2244

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

3903 Wiseman Blvd
Ste 100
San Antonio, TX 78251
Phone (210) 681-0126

3903 Wiseman Blvd
San Antonio, TX 78251
Phone (210) 681-0126

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

8026 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-8110

Interoperability endpoints

  • Direct secure messaging: grace.mukamana.1@1438.direct.athenahealth.com

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 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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1326256348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8711 VILLAGE DR STE 114",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175419",
            "telephone_number": "210-655-3800",
            "fax_number": "210-655-3801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8715 VILLAGE DR STE 418",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175407",
            "telephone_number": "210-655-3800",
            "fax_number": "210-655-3801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUKAMANA",
        "first_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "TX",
            "license": "N3913",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "N3913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210192501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.