Individual provider Active NPI

Manuel Camilo Endo Carvajal, MD

  • Infectious Disease Physician
  • San Antonio, TX
National Provider Identifier
1346760956
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
T5880 Issued in TX
Practice address
903 W Martin St
San Antonio, TX 78207-0903
Phone
(210) 358-3555
NPI assigned
Jun 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X T5880 TX
Student in an Organized Health Care Education/Training Program 390200000X
Infectious Disease Physician 207RI0200X T5880 TX Primary

Addresses

Primary practice location

903 W Martin St
San Antonio, TX 78207-0903

Mailing address

903 W Martin St
San Antonio, TX 78207-0903
Phone (210) 358-3555

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
I20220808003016 TX Practitioner - Internal MedicinePractitioner - Infectious Disease 4183993264 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Infectious Disease
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alamo Area Resource Center IncGroup PAC ID 7315246451, 4 clinicians
University of Texas Health Science Center at San AntonioGroup PAC ID 0042128548, 1,290 clinicians

Practice addresses (Care Compare)

303 N Frio St
San Antonio, TX 78207-3034
Phone (210) 625-7200

903 W Martin St
San Antonio, TX 78207-0903
Phone (210) 358-3400

Hospital & facility affiliations

  • University Health System Hospital, San Antonio, TX, CCN 450213

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T5880TXMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alamo Area Resource Center, Inc. Infectious Disease CurrentSince Jul 1, 2022 Accepting new patients
University of Texas Health Science Center at San Antonio Internal Medicine Current Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Jul 1, 2022 Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Jul 1, 2022 Accepting new patients
Bexar County Hospital District Past Accepting new patients
Renal Associates, P.a. PastSince Jul 1, 2022 Accepting new patients

Locations

303 N Frio St
San Antonio, TX 78207
Phone (210) 487-7827

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

8300 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-9300

903 W Martin St
San Antonio, TX 78207
Phone (210) 358-3400

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

Organizations & group practices 6

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": "1498262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1346760956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 W MARTIN ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782070903",
            "telephone_number": "210-358-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 W MARTIN ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782070903",
            "telephone_number": "210-358-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDO CARVAJAL",
        "first_name": "MANUEL CAMILO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-24",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "T5880",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "T5880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.