Individual provider Active NPI

Charles Francis Lanzillo III, M.D.

  • Emergency Medicine Physician
  • San Antonio, TX
National Provider Identifier
1417120312
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
Q6865 Issued in TX
Practice address
16088 San Pedro Ave
San Antonio, TX 78232
Phone
(310) 448-3972
NPI assigned
Apr 11, 2008
Last updated
Aug 1, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Q6865 TX Primary

Addresses

Primary practice location

16088 San Pedro Ave
San Antonio, TX 78232

Mailing address

1719 E 19TH Ave # 5C-East
Denver, CO 80218-1235
Phone (303) 839-6741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX, SD, MT, ND5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20150908000625 CA Practitioner - Emergency Medicine 3375859366 Reassigns benefits to 4 organizations
I20160210001396 TX Practitioner - Emergency Medicine 3375859366 Reassigns benefits to 2 organizations
I20170807003557 SD Practitioner - Emergency Medicine 3375859366 Reassigns benefits to 1 organization
I20230125002951 MT Practitioner - Emergency Medicine 3375859366 Reassigns benefits to 2 organizations
I20240816000484 ND Practitioner - Emergency Medicine 3375859366 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Albert Einstein College of Medicine of Yeshiva University, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Medical CenterGroup PAC ID 7416851381, shared by 2 NPIs, 78 clinicians

Practice addresses (Care Compare)

1301 15TH Ave W
Williston, ND 58801-3821
Phone (701) 774-7400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q6865TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center CurrentSince Jul 21, 2017 Accepting new patients
Mercy Hospital of Devils Lake CurrentSince Jun 2, 2024 Accepting new patients
Phillips County Hospital Assn CurrentSince Dec 1, 2022 Accepting new patients
St Josephs Hospital and Health Center CurrentSince Aug 21, 2024 Accepting new patients
Alvarado Emergency Medical Associates, Inc. Emergency Medicine CurrentSince Nov 5, 2017 Accepting new patients
Victoria Emergency Associates LLC Emergency Medicine CurrentSince Jan 6, 2016 Accepting new patients
Team Physicians of California Medical Group Inc Emergency Medicine CurrentSince Jul 1, 2017 Accepting new patients
Lone Star Emergency Associates LLC Emergency Medicine CurrentSince Nov 1, 2016 Accepting new patients
Regents of the Unviersity of California Emergency Medicine CurrentSince Aug 1, 2015 Accepting new patients
CMSC, LLC CurrentSince May 20, 2024 Accepting new patients
Team Physicians of Northern California Medical Group Inc Emergency Medicine CurrentSince Aug 1, 2017 Accepting new patients
Mercy Hospital of Devils Lake Current Accepting new patients
St. Joseph's Hospital and Health Center CurrentSince Aug 21, 2024 Accepting new patients
St Joseph's Hospital and Health Center Current Accepting new patients
Mercy Medical Center CurrentSince Mar 1, 2025 Accepting new patients
Regents of the University of California Emergency Medicine CurrentSince Aug 1, 2015 Accepting new patients
Mercy Hospital of Devils Lake Emergency Medicine CurrentSince Jun 2, 2024 Accepting new patients
Mercy Medical Center Current Accepting new patients
Mercy Home Care CurrentSince Mar 1, 2025 Accepting new patients
Mercy Medical Center Current Accepting new patients
St. Joseph's Hospital and Health Center Current Accepting new patients

Locations

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

5555 Grossmont Center Dr
La Mesa, CA 91942
Phone (619) 465-0711

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

File 54826
Los Angeles, CA 90074

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

6655 Alvarado Rd
San Diego, CA 92120
Phone (619) 229-3130

3290 Solutions Ctr
Chicago, IL 60677

3369 Solutions Ctr
Chicago, IL 60677

7360 Solutions Ctr
Chicago, IL 60677
Phone (701) 237-8033

1509 29th St S
Great Falls, MT 59405
Phone (406) 771-3500

3010 15th Ave S
Great Falls, MT 59405
Phone (406) 771-3095

1031 7th St NE
Devils Lake, ND 58301
Phone (701) 662-2131

2500 Fairway St
Dickinson, ND 58601
Phone (701) 456-4000

1213 15th Ave W
Williston, ND 58801
Phone (701) 572-7641

1301 15th Ave W
Williston, ND 58801
Phone (701) 774-7400

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

401 9th Ave NW
Watertown, SD 57201
Phone (605) 886-9317

506 E San Antonio St
Victoria, TX 77901
Phone (361) 575-1445

1200 Carl Ramert Dr
Yoakum, TX 77995
Phone (361) 293-2321

Organizations & group practices 21

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.

View all 21

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": "1207872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1417120312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 E 19TH AVE # 5C-EAST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802181235",
            "telephone_number": "303-839-6741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16088 SAN PEDRO AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78232",
            "telephone_number": "310-448-3972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANZILLO",
        "first_name": "CHARLES",
        "middle_name": "FRANCIS",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-11",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q6865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.