NPIMap

Organization Active NPI

San Antonio Kidney Disease Center Physicians Group, P.L.L.C.

  • Nephrology Physician
  • San Antonio, TX
National Provider Identifier
1356325922
Registry record updated Feb 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
SAN ANTONIO KIDNEY DISEASE CENTER PHYSICIANS GROUP, P.L.L.C.
Practice address
7142 San Pedro Ave
Ste 120
San Antonio, TX 78216-6256
Phone
(210) 661-5622
Fax
(210) 798-6811
NPI assigned
Dec 6, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2013

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

Authorized official

Name
Veronica Aguirre
Title
Assistance Administrator
Phone
(210) 661-5622

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

7142 San Pedro Ave
Ste 120
San Antonio, TX 78216-6256

Mailing address

7142 San Pedro Ave
Ste 120
San Antonio, TX 78216-6256
Phone (210) 661-5622

Other identifiers 2

IdentifierTypeStateIssuer
097331503MedicaidTX
CC8120OtherTXMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031105000750 TX Part B Supplier - Clinic/Group Practice 2668384744 Receives reassigned benefits from 35 practitioners
Practice locations: San Antonio, TX; Schertz, TX; Seguin, TX; Pleasanton, TX; Boerne, TX; Castroville, TX; Floresville, TX; Hondo, TX…

National Provider Directory

National Provider Directory
Tax ID family
San Antonio Kidney Disease Center Physicians Group PLLC32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

Locations

409 Madrid St
Castroville, TX 78009
Phone (210) 692-7228

495 10th St
Ste 102
Floresville, TX 78114
Phone (830) 216-2606

222 Sidney Baker St S
Ste 208
Kerrville, TX 78028
Phone (830) 896-7607

12881 N Interstate 35
Ste 302
Live Oak, TX 78233
Phone (210) 654-7326

6700 Randolph Blvd
Ste 102
Live Oak, TX 78233
Phone (210) 654-7326

2660 E Common St
New Braunfels, TX 78130
Phone (830) 214-7640

2660 E Common St
Ste 201
New Braunfels, TX 78130
Phone (830) 620-4650

8042 Wurzbach Rd
Ste 500
San Antonio, TX 78229
Phone (210) 692-7228

4242 E Southcross Blvd
Ste 4
San Antonio, TX 78222
Phone (210) 337-4911

4330 Medical Dr
Ste 105
San Antonio, TX 78229
Phone (210) 692-7228

3124 Sidney Brooks St
Ste 570B2
San Antonio, TX 78235
Phone (210) 337-4911

731 Carnoustie Dr
Ste 102
San Antonio, TX 78258
Phone (210) 495-8280

18707 Hardy Oak Blvd
Ste 530
San Antonio, TX 78258
Phone (210) 495-8280

11212 State Highway 151
Ste 290
San Antonio, TX 78251
Phone (210) 257-0953

8601 Village Dr
Ste 226
San Antonio, TX 78217
Phone (210) 224-1771

10010 Rogers Xing
San Antonio, TX 78251
Phone (210) 539-0996

17331 Interstate 35 N
Ste 107
Schertz, TX 78154

Practitioners & affiliated clinicians

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360195200000",
    "number": "1356325922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7142 SAN PEDRO AVE",
            "address_2": "STE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166256",
            "telephone_number": "210-661-5622",
            "fax_number": "210-798-6811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7142 SAN PEDRO AVE",
            "address_2": "STE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166256",
            "telephone_number": "210-661-5622",
            "fax_number": "210-798-6811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANTONIO KIDNEY DISEASE CENTER PHYSICIANS GROUP, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-06",
        "last_updated": "2013-02-07",
        "status": "A",
        "authorized_official_last_name": "AGUIRRE",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "ASSISTANCE ADMINISTRATOR",
        "authorized_official_telephone_number": "210-661-5622"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "097331503",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CC8120",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.