NPIMap

Individual provider Active NPI

Michael Wayne Vermeulen, PA

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1407829872
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA04518 Issued in TX
Practice address
5206 Research Dr
San Antonio, TX 78240-5251
Phone
(210) 595-5300
Fax
(210) 614-8740
NPI assigned
Feb 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA04518 TX
Physician Assistant 363A00000X PA04518 TX Primary

Addresses

Primary practice location

5206 Research Dr
San Antonio, TX 78240-5251

Mailing address

PO Box 911230
Dallas, TX 75391-1230
Phone (210) 595-5300

Other identifiers 1

IdentifierTypeStateIssuer
217869101MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051014000558 TX Practitioner - Physician Assistant 6002832417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Oncology PAGroup PAC ID 5395658934, 1,001 clinicians

Practice addresses (Care Compare)

1448 Common St
New Braunfels, TX 78130-3162
Phone (830) 643-1762

2026 S Jackson St
Jacksonville, TX 75766-5822
Phone (903) 586-2456

5206 Research Dr
San Antonio, TX 78240-5251
Phone (210) 595-5300

7848 Gateway Blvd E
El Paso, TX 79915-1815
Phone (915) 599-1313

PO Box
Suite 911242
Dallas, TX 75391-1242

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.12 of 100Reported as apm
Quality
67.48
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1390COMDAddiction (Substance Use Disorder) Counselor
37560COMDSpinal Cord Injury Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Front Range Emergency Specialists, PC Past Accepting new patients
Texas Oncology PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: michael.vermeulen@txo.ikm.direct-ci.com

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 6

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1407829872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911230",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753911230",
            "telephone_number": "210-595-5300",
            "fax_number": "210-595-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5206 RESEARCH DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782405251",
            "telephone_number": "210-595-5300",
            "fax_number": "210-614-8740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERMEULEN",
        "first_name": "MICHAEL",
        "middle_name": "WAYNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-08",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA04518",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "217869101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.