Individual provider Active NPI

Andres Nisimblat, M.D.

  • Family Medicine Physician
  • Corpus Christi, TX
National Provider Identifier
1467469205
Registry record updated Aug 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L3771 Issued in TX
Practice address
6200 Saratoga Blvd
BLDG 5
Corpus Christi, TX 78414-3477
Phone
(361) 225-2255
Fax
(361) 854-3672
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L3771 TX Primary

Addresses

Primary practice location

6200 Saratoga Blvd
BLDG 5
Corpus Christi, TX 78414-3477

Mailing address

6200 Saratoga Blvd
BLDG 5
Corpus Christi, TX 78414-3477
Phone (361) 225-2255

Other identifiers 1

IdentifierTypeStateIssuer
152221102MedicaidTX

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
I20041006000822 TX Practitioner - Family Practice 0648239673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shea Physical Therapy Specialists LLCGroup PAC ID 6204245194, 194 clinicians
Corpus Christi Medical Associates, P.a.Group PAC ID 3577741552, 6 clinicians

Practice addresses (Care Compare)

5440 Everhart Rd
Suite 1
Corpus Christi, TX 78411-4838
Phone (361) 994-5224

6200 Saratoga Blvd
Unit 5
Corpus Christi, TX 78414-3478
Phone (361) 225-2255

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Corpus Christi Medical Associates, P.a. Family Medicine CurrentSince Jul 1, 2011 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

6200 Saratoga Blvd
Unit 5
Corpus Christi, TX 78414
Phone (361) 225-2255

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313971200000",
    "number": "1467469205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 SARATOGA BLVD",
            "address_2": "BLDG 5",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784143477",
            "telephone_number": "361-225-2255",
            "fax_number": "361-854-3672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 SARATOGA BLVD",
            "address_2": "BLDG 5",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784143477",
            "telephone_number": "361-225-2255",
            "fax_number": "361-854-3672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NISIMBLAT",
        "first_name": "ANDRES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2011-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L3771",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152221102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.