Individual provider Active NPI

Jesus N. De Luna Jr., PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1356715155
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP129646 Issued in TX
Practice address
6812 Bandera Rd Ste 102
San Antonio, TX 78238-1378
Phone
(210) 808-2540
NPI assigned
Nov 17, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP129646 TX Primary

Addresses

Primary practice location

6812 Bandera Rd Ste 102
San Antonio, TX 78238-1378

Mailing address

6800 Park Ten Blvd Ste 200S
San Antonio, TX 78213-4293
Phone (210) 261-1060

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151223000075 TX Practitioner - Nurse Practitioner 7618278318 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Procare Wellness, LLC Psychiatric/Mental Health CurrentSince Jul 1, 2024 Accepting new patients
Bexar County Board of Trustees for Mental Health Mental Retardation CurrentSince Nov 24, 2015 Accepting new patients

Locations

6800 Park Ten Blvd
Ste 200S
San Antonio, TX 78213
Phone 21026110001060

6812 Bandera Rd
Ste 102
San Antonio, TX 78238
Phone (210) 261-3350

8601 Village Dr
Ste 100
San Antonio, TX 78217
Phone (210) 210-2170

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1356715155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 PARK TEN BLVD STE 200S",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782134293",
            "telephone_number": "210-261-1060",
            "fax_number": "210-261-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6812 BANDERA RD STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782381378",
            "telephone_number": "210-808-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LUNA",
        "first_name": "JESUS",
        "middle_name": "N.",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-17",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP129646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.