Individual provider Active NPI

Mariana Obregon, FNP-C

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1366017410
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1035157 Issued in TX
Practice address
5114 Medical Dr Apt 2345
San Antonio, TX 78229-3877
Phone
(956) 590-9669
NPI assigned
May 21, 2021
Last updated
May 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1035157 TX Primary

Addresses

Primary practice location

5114 Medical Dr Apt 2345
San Antonio, TX 78229-3877

Mailing address

5114 Medical Dr Apt 2345
San Antonio, TX 78229-3877
Phone (956) 590-9669

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
I20230622003297 TX Practitioner - Nurse Practitioner 7113385162 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1035157TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dagoberto Martinez, Mdpa CurrentSince Apr 1, 2023 Accepting new patients

Locations

3855 Southmost Rd
Brownsville, TX 78521
Phone (956) 544-2001

95 E Price Rd
Bldg A
Brownsville, TX 78521
Phone (956) 504-6080

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1366017410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5114 MEDICAL DR APT 2345",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293877",
            "telephone_number": "956-590-9669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5114 MEDICAL DR APT 2345",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293877",
            "telephone_number": "956-590-9669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBREGON",
        "first_name": "MARIANA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-21",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1035157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.