Individual provider Active NPI

Carissa Kimsa Nguyen Ford, MD

  • Emergency Medicine Physician
  • San Antonio, TX
National Provider Identifier
1336768290
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
U2846 Issued in TX
Practice address
4502 Medical Dr
San Antonio, TX 78229-4402
Phone
(210) 358-2078
Fax
(210) 702-6274
NPI assigned
Apr 10, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X U2846 TX Primary

Addresses

Primary practice location

4502 Medical Dr
San Antonio, TX 78229-4402

Mailing address

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-2078

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
I20230510002429 TX Practitioner - Emergency Medicine 2567836398 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Texas Medical Branch at Galveston, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Services of TX, PLLCGroup PAC ID 3375909351, 374 clinicians

Practice addresses (Care Compare)

500 W Medical Ctr Blvd
HCA Houston Clear Lake Hospital
Webster, TX 77598-4220
Phone (281) 332-2511

Hospital & facility affiliations

  • HCA Houston Healthcare Clear Lake Hospital, Webster, TX, CCN 450617

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at San Antonio Current Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Jul 1, 2023 Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Jul 1, 2023 Accepting new patients
Emergency Medicine Services of TX, PLLC Emergency Medicine CurrentSince Aug 1, 2024 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

225 E Parkwood Ave
Friendswood, TX 77546
Phone (281) 549-9400

11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

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

26306 Kuykendahl Rd
Tomball, TX 77375
Phone (346) 246-7700

500 W Medical Center Blvd
Webster, TX 77598
Phone (713) 447-4650

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": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1336768290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-2078",
            "fax_number": "210-702-6274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-2078",
            "fax_number": "210-702-6274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "CARISSA",
        "middle_name": "KIMSA NGUYEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-10",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "U2846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.