Individual provider Active NPI

Russell L Woodard, M.D.

  • Surgery Physician
  • San Antonio, TX
National Provider Identifier
1346274800
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
J5065 Issued in TX
Practice address
8122 Datapoint Dr Ste 320
San Antonio, TX 78229-3264
Phone
(210) 614-5113
Fax
(210) 616-0024
NPI assigned
Jul 10, 2006
Last updated
Oct 4, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X J5065 TX
Surgery Physician 208600000X J5065 TX Primary

Addresses

Primary practice location

8122 Datapoint Dr Ste 320
San Antonio, TX 78229-3264

Mailing address

8122 Datapoint Dr Ste 320
San Antonio, TX 78229-3264
Phone (210) 614-5113

Other identifiers 1

IdentifierTypeStateIssuer
103615401MedicaidTX

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
I20100712000390 TX Practitioner - General Surgery 5496703969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Tennessee, HSC, College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
General Surgical AssociatesGroup PAC ID 1557396512, 9 clinicians

Practice addresses (Care Compare)

8122 Datapoint Dr
Suite 320
San Antonio, TX 78229-3264
Phone (210) 614-5113

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)18
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux12
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J5065TXMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
General Surgical Associates Specialist CurrentSince Jul 28, 1993 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

8042 Wurzbach Rd
Ste 310
San Antonio, TX 78229
Phone (210) 614-5113

8122 Datapoint Dr
Ste 320
San Antonio, TX 78229
Phone (210) 614-5113

Interoperability endpoints

  • Direct secure messaging: russell.woodard@gsa.eclinicaldirectplus.com

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 3

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1346274800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8122 DATAPOINT DR STE 320",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293264",
            "telephone_number": "210-614-5113",
            "fax_number": "210-616-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8122 DATAPOINT DR STE 320",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293264",
            "telephone_number": "210-614-5113",
            "fax_number": "210-616-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODARD",
        "first_name": "RUSSELL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "J5065",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "J5065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103615401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.