Javier Carrillo

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1084113 Issued in TX

Practice address

1303 McCullough Ave Ste 248
San Antonio, TX 78212-5604

Phone

(210) 220-3737

Fax

(210) 220-3747

NPI assigned

Feb 18, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Daniel Juarez, MD PA

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1265535405
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1455753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1427417468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 MCCULLOUGH AVE STE 248",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782125604",
            "telephone_number": "210-220-3737",
            "fax_number": "210-220-3747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 MCCULLOUGH AVE STE 248",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782125604",
            "telephone_number": "210-220-3737",
            "fax_number": "210-220-3747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "JAVIER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-18",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "TX",
            "license": "770391",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1084113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bianca Vanessa Carrillo, M.A., CCC-SLP, CDP
• Caleb Carrillo
• Eileen Carrillo, FA
• Erika Carrillo
• Haylee Marie Carrillo
• Jazmine Carrillo, CNP
• Kristi Carrillo, COTA/L
• Lizbeth Carrillo
• Luis Carrillo, MD
• Maegan B Carrillo

• Family Nurse Practitioner in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.

Verify at the official NPI Registry.