Individual provider Active NPI

Ryan Robles, FNP -BC,PMHNP-BC

  • Primary Care Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1326574773
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AP133922 Issued in TX
Practice address
5307 Broadway St Ste 200
San Antonio, TX 78209-5737
Phone
(210) 824-3130
Fax
(210) 579-3130
NPI assigned
May 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP133922 TX
Primary Care Nurse Practitioner 363LP2300X AP133922 TX Primary
Family Nurse Practitioner 363LF0000X AP133922 TX

Addresses

Primary practice location

5307 Broadway St Ste 200
San Antonio, TX 78209-5737

Mailing address

5307 Broadway St Ste 200
San Antonio, TX 78209-5737
Phone (210) 824-3130

Other practice location 1

4242 Woodcock Dr Ste 201
San Antonio, TX 78228-1325
Phone (210) 481-8673

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190528001908 TX Practitioner - Nurse Practitioner 2365785714 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa of Texas PLLC Current Accepting new patients
Vpa of Texas PLLC CurrentSince Feb 1, 2023 Accepting new patients
Vpa of Texas PLLC CurrentSince Feb 1, 2023 Accepting new patients

Locations

5414 Fredericksburg Rd
Ste 100A
San Antonio, TX 78229
Phone (210) 468-0800

Organizations & group practices 3

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": "1493856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1326574773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5307 BROADWAY ST STE 200",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782095737",
            "telephone_number": "210-824-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5307 BROADWAY ST STE 200",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782095737",
            "telephone_number": "210-824-3130",
            "fax_number": "210-579-3130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4242 Woodcock Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782281325",
            "country_code": "US",
            "telephone_number": "210-481-8673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBLES",
        "first_name": "RYAN",
        "credential": "FNP -BC,PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-04",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP133922",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP133922",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP133922",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.