Individual provider Active NPI

Maria Teresa Trevino Whitney, M.D.

  • Ophthalmology Physician
  • San Antonio, TX
National Provider Identifier
1376720730
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
N1493 Issued in TX
Practice address
4114 Pond Hill Rd
Ste 202
San Antonio, TX 78231-1273
Phone
(210) 200-8805
Fax
(210) 200-8543
NPI assigned
Jan 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X N1493 TX Primary

Addresses

Primary practice location

4114 Pond Hill Rd
Ste 202
San Antonio, TX 78231-1273

Mailing address

4114 Pond Hill Rd
Ste 202
San Antonio, TX 78231-1273
Phone (210) 200-8805

Other identifiers 1

IdentifierTypeStateIssuer
204402603MedicaidTX

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090820000611 TX Practitioner - OphthalmologyPractitioner - Internal Medicine 3779637038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OphthalmologyAlso: Internal Medicine
Education
Baylor College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4114 Pond Hill Rd
Suite 202
San Antonio, TX 78231-1273
Phone (210) 200-8805

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Shavano Eye Center PLLC Ophthalmology CurrentSince Jan 17, 2021 Accepting new patients
San Antonio Eye Center PA Past Accepting new patients

Locations

4114 Pond Hill Rd
Ste 202
Shavano Park, TX 78231
Phone (210) 200-8805

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": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1376720730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4114 POND HILL RD",
            "address_2": "STE 202",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782311273",
            "telephone_number": "210-200-8805",
            "fax_number": "210-200-8543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4114 POND HILL RD",
            "address_2": "STE 202",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782311273",
            "telephone_number": "210-200-8805",
            "fax_number": "210-200-8543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITNEY",
        "first_name": "MARIA",
        "middle_name": "TERESA TREVINO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-29",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "N1493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204402603",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.