Trent J Fackelman, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1007822 Issued in TX

Practice address

8500 Village Dr Ste 202
San Antonio, TX 78217-5510

Phone

(210) 957-1419

Fax

(210) 957-1697

NPI assigned

Aug 4, 2020

Last updated

Sep 13, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Metro North Cardiovascular Associates, P.a.Group PAC ID 8022033364, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DHJBBD

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.

• Metro North Cardiovascular Associates, P.a

  • Specialist
  • San Antonio, TX
  • NPI 1962602763
  Medicare reassignment Care Compare group NPD
• Heroes Healthcare PLLC

  dba Hereos Healthcare Primary Care

  • Primary Care Clinic/Center
  • San Antonio, TX
  • NPI 1770184012
  NPD Authorized official

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1407466410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 KERRI STRUG CV",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787482077",
            "telephone_number": "210-655-9613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8500 VILLAGE DR STE 202",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175510",
            "telephone_number": "210-957-1419",
            "fax_number": "210-957-1697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FACKELMAN",
        "first_name": "TRENT",
        "middle_name": "J",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-04",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "816398",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1007822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marielle Fabrigas
• Mia Fabro
• Mara Facha, MA CCC-SLP
• Facial & Oculoplastic Surgery Center of Texas, PLLC (Eyeplastx)
• Jeremy David Fackelman, MS STUDENT COUNSELOR
• Zachary William Fackler, DC
• Fact Consulting of Sa, LLC
• Elyas Fadaee, MD
• Olusegun Kehinde Fadairo
• Jasmine Fadhil

• Family Nurse Practitioner in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.