Organization Active NPI

Endocrinology Nuclear Medicine Associates PA

  • Endocrinology, Diabetes & Metabolism Physician
  • San Antonio, TX
National Provider Identifier
1366581589
Registry record updated Nov 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
ENDOCRINOLOGY NUCLEAR MEDICINE ASSOCIATES PA
Practice address
1303 McCullough Ave
Suite 374
San Antonio, TX 78212-5615
Phone
(210) 223-5483
Fax
(210) 223-5492
NPI assigned
Feb 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2011

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

Authorized official

Name
Mrs. Yolanda M Lopez
Title
Office Manager
Phone
(210) 223-5483

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

1303 McCullough Ave
Suite 374
San Antonio, TX 78212-5615

Mailing address

1303 McCullough Ave
Suite 374
San Antonio, TX 78212-5615
Phone (210) 223-5483

Other identifiers 1

IdentifierTypeStateIssuer
083522501MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040621000477 TX Part B Supplier - Clinic/Group Practice 5597740100 Receives reassigned benefits from 6 practitioners
Practice locations: San Antonio, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0660420Endocrinology Nuclear Medicine1303 McCullough Ave Suite 374, San Antonio, TX 78212Certificate of waiverNov 1, 2027

National Provider Directory

National Provider Directory

Locations

1303 McCullough Ave
Ste 374
San Antonio, TX 78212
Phone (210) 223-5483

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1181

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321920000000",
    "number": "1366581589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 MCCULLOUGH AVE",
            "address_2": "SUITE 374",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782125615",
            "telephone_number": "210-223-5483",
            "fax_number": "210-223-5492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 MCCULLOUGH AVE",
            "address_2": "SUITE 374",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782125615",
            "telephone_number": "210-223-5483",
            "fax_number": "210-223-5492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOCRINOLOGY NUCLEAR MEDICINE ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2011-11-22",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "YOLANDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "210-223-5483",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "083522501",
            "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 Nov 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.