Tulamarie Alexies Derencius, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA11095 Issued in TX

Practice address

22135 Bulverde Rd Ste 106
San Antonio, TX 78259-1849

Phone

(281) 783-8162

NPI assigned

Mar 3, 2009

Sex

Female

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

Credentials

Physician Assistant

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.

• Fast Track Urgent Care

  • Urgent Care Clinic/Center
  • San Antonio, TX
  • NPI 1497151237

  TX

  Medicare reassignment
• Nluc PLLC

  • Urgent Care Clinic/Center
  • Houston, TX
  • NPI 1518209113

  TX

  Medicare reassignment
• Ucp Physicians of Central Texas, PLLC

  • Urgent Care Clinic/Center
  • Georgetown, TX
  • NPI 1922289412

  TX

  Medicare reassignment
• Fast Track Urgent Care - Bastrop

  • Urgent Care Clinic/Center
  • Bastrop, TX
  • NPI 1962193680

  Physician Assistant

  NPD
• Nluc PLLC

  • Urgent Care Clinic/Center
  • League City, TX
  • NPI 1043814049
  NPD
• Ucp Physicians of Central Texas, PLLC

  • Urgent Care Clinic/Center
  • Austin, TX
  • NPI 1154472967
  NPD

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1447490404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 BRIARPARK DR STE 575",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770423776",
            "telephone_number": "832-626-2842",
            "fax_number": "832-626-2842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22135 BULVERDE RD STE 106",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782591849",
            "telephone_number": "281-783-8162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36000 Darnall Loop",
            "address_2": "Carl R. Darnall Army Medical Center",
            "address_purpose": "LOCATION",
            "city": "Fort Hood",
            "state": "TX",
            "postal_code": "76544",
            "country_code": "US",
            "telephone_number": "254-251-9762",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22906 US Highway 281 N Ste 108",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782587635",
            "country_code": "US",
            "telephone_number": "210-774-5020",
            "fax_number": "210-774-5019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DERENCIUS",
        "first_name": "TULAMARIE",
        "middle_name": "ALEXIES",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-03",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "1086040",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Derdak, D.O.
• Lindsey Rausch Dereadt, CCC-SLP
• Derek H Elder LPC PLLC
• Valerie Deremer, PA
• Anthony Derencius, PA-C
• Mohamed Derhab, MD
• Rob Ert Parris Derington, LAT
• Susan Marie Derk, OTR
• Marilyn Kay Derkowski, RPH
• Derm Docs PLLC

• All providers in San Antonio, TX
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.