Individual provider Active NPI

Molly D Trevino

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1376147173
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1012052 Issued in TX
Practice address
5364 Fredericksburg Rd Ste 100
San Antonio, TX 78229-6107
Phone
(210) 802-7003
Fax
(210) 519-2970
NPI assigned
Nov 23, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 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 1012052 TX Primary

Addresses

Primary practice location

5364 Fredericksburg Rd Ste 100
San Antonio, TX 78229-6107

Mailing address

14345 Blanco Rd
San Antonio, TX 78216-7723
Phone (210) 618-6084

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
I20210322000083 TX Practitioner - Nurse Practitioner 7810304730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Pain Partners PLLCGroup PAC ID 3274061783, 23 clinicians

Practice addresses (Care Compare)

3202 Cherry Ridge Dr
Suite 103
San Antonio, TX 78230-4830
Phone (210) 441-4333

Hospital & facility affiliations

  • Baptist Medical Center Hospital, San Antonio, TX, CCN 450058

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1012052TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Pain Partners PLLC CurrentSince Nov 1, 2024 Accepting new patients
Texas Pain Partners PLLC CurrentSince Nov 1, 2024 Accepting new patients

Locations

7525 N Loop 1604 E
Ste 128
Live Oak, TX 78233
Phone (210) 441-4333

423 Treeline Park
Ste 325
San Antonio, TX 78209
Phone (210) 546-1460

5364 Fredericksburg Rd
Ste 100
San Antonio, TX 78229
Phone (210) 441-4333

3202 Cherry Ridge Dr
Ste 103
San Antonio, TX 78230
Phone (210) 441-4333

7003 S New Braunfels Ave
Ste 106
San Antonio, TX 78223
Phone (210) 441-4333

45 NE Loop 410
Ste 850
San Antonio, TX 78216

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1376147173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14345 BLANCO RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782167723",
            "telephone_number": "210-618-6084",
            "fax_number": "210-519-2970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5364 FREDERICKSBURG RD STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782296107",
            "telephone_number": "210-802-7003",
            "fax_number": "210-519-2970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVINO",
        "first_name": "MOLLY",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-23",
        "last_updated": "2021-02-12",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1012052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.