Individual provider Active NPI

Nathalie Rose Tiberio, M.D.

  • Pediatrics Physician
  • San Antonio, TX
National Provider Identifier
1346771433
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
S5793 Issued in TX
Practice address
3066 E Commerce St
San Antonio, TX 78220-1013
Phone
(210) 233-7000
NPI assigned
Mar 21, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X S5793 TX Primary

Addresses

Primary practice location

3066 E Commerce St
San Antonio, TX 78220-1013

Mailing address

3066 E Commerce St
San Antonio, TX 78220-1013
Phone (210) 233-7000

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
I20220520000196 TX Practitioner - Pediatric Medicine 3870970445 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S5793TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barrio Comprehensive Family Health Care Center, Inc. Single Specialty Current Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince May 12, 2022 Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince May 12, 2022 Accepting new patients
Aquarius Pediatrics Single Specialty PastSince Aug 1, 2020 Accepting new patients

Locations

1102 Barclay St
San Antonio, TX 78207
Phone (210) 434-0513

3066 E Commerce St
San Antonio, TX 78220
Phone (210) 233-7062

14625 Huebner Rd
San Antonio, TX 78230

Interoperability endpoints

  • Direct secure messaging: nathalie.tiberio@commsa.eclinicaldirectplus.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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1346771433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3066 E COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782201013",
            "telephone_number": "210-233-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3066 E COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782201013",
            "telephone_number": "210-233-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBERIO",
        "first_name": "NATHALIE",
        "middle_name": "ROSE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-21",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "S5793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.