Ilene Nicole Pardo, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1170306 Issued in TX

Practice address

9011 Poteet Jourdanton Fwy
San Antonio, TX 78224-2124

Phone

(210) 922-7000

Fax

(210) 924-1374

NPI assigned

Jul 12, 2024

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

Other names 1

• Ilene Nicole Diaz Former name

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

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ilene.pardo.p1@direct.centromed.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• El Centro del Barrio, Inc.

  dba CentroMed South Park Medical Clinic

  • Federally Qualified Health Center (FQHC)
  • San Antonio, TX
  • NPI 1538264429
  Medicare reassignment NPD
• El Centro del Barrio, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Antonio, TX
  • NPI 1861211567
  NPD
• El Centro del Barrio, Inc.

  dba Dullnig House Clinic

  • Federally Qualified Health Center (FQHC)
  • San Antonio, TX
  • NPI 1154495182
  NPD (past)
• El Centro del Barrio, Inc.

  dba Palo Alto Clinic

  • Federally Qualified Health Center (FQHC)
  • San Antonio, TX
  • NPI 1730388018
  NPD (past)

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

{
    "created_epoch": "1720742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1467299727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3750 COMMERCIAL AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782213117",
            "telephone_number": "210-922-7000",
            "fax_number": "210-924-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9011 POTEET JOURDANTON FWY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782242124",
            "telephone_number": "210-922-7000",
            "fax_number": "210-924-1374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARDO",
        "first_name": "ILENE",
        "middle_name": "NICOLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-12",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1170306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ILENE",
            "last_name": "DIAZ",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maya Parappuram
• Erica Elena Parazo, DPT
• Reena Pardiwala, PA-C
• Juan Jose Pardo Granados
• Catherine Pardo
• Kalasofia Pardo
• Maria Isabel Pardo, FNP-BC
• Gabriela G Paredes Zertuche, RDN, LD
• Cassandra Guadalupe Paredes-Aguilar
• Alexandra D Paredes, CCC-SLP

• 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 Aug 1, 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.