Individual provider Active NPI

Jose Quijada

  • Pediatrics Physician
  • San Antonio, TX
National Provider Identifier
1457700049
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
S2150 Issued in TX
Practice address
14811 San Pedro Ave
San Antonio, TX 78232
Phone
(210) 494-7758
Fax
(210) 494-2353
NPI assigned
Jun 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X S2150 TX Primary

Addresses

Primary practice location

14811 San Pedro Ave
San Antonio, TX 78232

Mailing address

3066 E Commerce St
San Antonio, TX 78220-1013
Phone (210) 233-7000

Other practice location 1

14811 San Pedro Ave
San Antonio, TX 78232
Phone (210) 494-7758

Other practice location 2

3046 Shady Park Dr
Houston, TX 77017-2423
Phone (832) 537-1011

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
I20190627001564 TX Practitioner - Pediatric Medicine 8022342872 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S2150TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Jun 10, 2019 Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. Current Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Jun 10, 2019 Accepting new patients

Locations

14625 Huebner Rd
San Antonio, TX 78230

1102 Barclay St
San Antonio, TX 78207
Phone (210) 434-0513

3066 E Commerce St
San Antonio, TX 78220
Phone (210) 233-7062

14811 San Pedro Ave
San Antonio, TX 78232
Phone (210) 494-7758

Interoperability endpoints

  • Direct secure messaging: jose.quijada@commsa.eclinicaldirectplus.com

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": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1457700049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3066 E COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782201013",
            "telephone_number": "210-233-7000",
            "fax_number": "210-434-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14811 SAN PEDRO AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78232",
            "telephone_number": "210-494-7758",
            "fax_number": "210-494-2353"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14811 San Pedro Ave",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "78232",
            "country_code": "US",
            "telephone_number": "210-494-7758",
            "fax_number": "210-494-2353",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3046 Shady Park Dr",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770172423",
            "country_code": "US",
            "telephone_number": "832-537-1011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUIJADA",
        "first_name": "JOSE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-06",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "S2150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.