Active NPI
Korina M Deleon, M.D.
- Pediatrics Physician
- San Antonio, TX
National Provider Identifier
1417142134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- M5125
- Practice address
- 7007 Bandera Rd
Ste 19
San Antonio, TX 78238-1138 - Phone
- (210) 680-6000
- Fax
- (210) 680-9153
- NPI assigned
- Sep 6, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | M5125 | TX | Primary |
Addresses
Primary practice location
7007 Bandera Rd
Ste 19
San Antonio, TX 78238-1138
Mailing address
333 N Santa Rosa St
Suite D4023
San Antonio, TX 78207-3108
Phone (469) 282-2711
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8G8248 | Other | TX | BCBS |
| 190037502 | Medicaid | TX | |
| 94981 | Other | TX | CARELINK |
| 1201900375 | Medicaid | TX | |
| J0150244 | Other | TX | DPS REGISTRATION |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M5125 | TX | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christus Trinity Clinic Texas | Current | Accepting new patients | |
| Christus Trinity Clinic Texas | Pediatrics | Current | Accepting new patients |
| Northwest Pediatric Associates | Past | Accepting new patients |
Locations
8366 N Loop 1604 W
Ste 105
San Antonio, TX 78249
Phone (210) 680-6000
630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888
Interoperability endpoints
- kdeleon282943@christushealth.direct-ci.net
Organizations & group practices 3
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.
-
- Rural Health Clinic/Center
- Winnsboro, TX
- NPI 1801673165
-
- Specialist
- San Antonio, TX
- NPI 1952446593
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1417142134",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 N SANTA ROSA ST",
"address_2": "SUITE D4023",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782073108",
"telephone_number": "469-282-2711",
"fax_number": "469-282-2609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7007 BANDERA RD",
"address_2": "STE 19",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782381138",
"telephone_number": "210-680-6000",
"fax_number": "210-680-9153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELEON",
"first_name": "KORINA",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-06",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "M5125",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8G8248",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "190037502",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARELINK",
"identifier": "94981",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1201900375",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DPS REGISTRATION",
"identifier": "J0150244",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.