Individual provider Active NPI

Andrea Bali

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1407539893
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1130982 Issued in TX
Practice address
1211 Austin Hwy Ste 110
San Antonio, TX 78209-4980
Phone
(210) 774-5010
NPI assigned
Aug 10, 2023
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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 1130982 TX Primary

Addresses

Primary practice location

1211 Austin Hwy Ste 110
San Antonio, TX 78209-4980

Mailing address

1211 Austin Hwy Ste 110
San Antonio, TX 78209-4980

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
I20240207002398 TX Practitioner - Nurse Practitioner 8123461084 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1211 Austin Hwy
Suite 110
San Antonio, TX 78209-4980
Phone (210) 774-5010

1240 E Palm Valley Blvd
Round Rock, TX 78664-3202
Phone (512) 733-9100

7110 FM
78 Suite 110
San Antonio, TX 78244-1765
Phone (210) 310-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1130982TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ucp Physicians of Central Texas, PLLC CurrentSince Nov 27, 2023 Accepting new patients
Primamed Physicians PLLC CurrentSince May 1, 2024 Accepting new patients
Primamed Physicians PLLC CurrentSince May 1, 2024 Accepting new patients
Ucp Physicians of Central Texas, PLLC Current Accepting new patients
Citimed, P.a. Past Accepting new patients

Locations

4401 Little Rd
Ste 520
Arlington, TX 76016
Phone (682) 318-3114

6001 W William Cannon Dr
Ste 302
Austin, TX 78749
Phone (512) 288-3627

11888 Marsh Ln
Ste 104
Dallas, TX 75234
Phone (972) 488-9222

1331 Northpark Dr
Kingwood, TX 77339
Phone (281) 359-5330

3304 Alma Dr
Plano, TX 75023
Phone (972) 424-6581

1240 E Palm Valley Blvd
Round Rock, TX 78664
Phone (512) 733-9100

1211 Austin Hwy
Ste 110
San Antonio, TX 78209
Phone (210) 774-5010

Interoperability endpoints

  • Direct secure messaging: andrea.bali.p6@direct.nextcare.nextgenshare.com

Organizations & group practices 5

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": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1407539893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 AUSTIN HWY STE 110",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782094980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 AUSTIN HWY STE 110",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782094980",
            "telephone_number": "210-774-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALI",
        "first_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-10",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1130982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.