John Paul Nieto, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA12192 Issued in TX

Practice address

510 Med CT Ste 210
San Antonio, TX 78258-3484

Phone

(210) 494-4290

Fax

(210) 494-4809

NPI assigned

Aug 7, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Interoperability endpoints

• Direct secure messaging: john.nieto.1@20876.direct.athenahealth.com

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.

• Yolanda Marcos MD PA

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1457616534
  Medicare reassignment
• Hillside Primary Care PLLC

  • Internal Medicine Physician
  • Live Oak, TX
  • NPI 1205349040
  NPD (past)

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1447739834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 MED CT STE 210",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583484",
            "telephone_number": "210-494-4290",
            "fax_number": "210-494-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 MED CT STE 210",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583484",
            "telephone_number": "210-494-4290",
            "fax_number": "210-494-4809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIETO",
        "first_name": "JOHN",
        "middle_name": "PAUL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-07",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA12192",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Amanda Nietfeld, MD
• Christlin Nieto-Jimenez, LMSW
• Alexandra Nieto
• Daisy Tovar Nieto, LCSW
• Hillary Aurora Nieto, NP
• Mayra Nieto, LPC
• Natalie Senonae Nieto, DNP, APRN, FNP-BC
• Rene Nieto
• Sandra L Nieto, M.D.
• Brian C Nietz, PT DPT MTC

• Physician Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; 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.