Individual provider Active NPI

Korina M Deleon, M.D.

  • Pediatrics Physician
  • San Antonio, TX
National Provider Identifier
1417142134
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
M5125 Issued in TX
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

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
8G8248OtherTXBCBS
190037502MedicaidTX
94981OtherTXCARELINK
1201900375MedicaidTX
J0150244OtherTXDPS 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071213000428 TX Practitioner - Pediatric Medicine 5890885941 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M5125TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Jan 1, 2022 Accepting new patients
Christus Trinity Clinic Texas Pediatrics CurrentSince Jan 1, 2022 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.