Organization Active NPI

Bruce L. Winter M.D. P.a.

  • Ophthalmology Physician
  • San Antonio, TX
National Provider Identifier
1477747772
Registry record updated Oct 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
BRUCE L. WINTER M.D. P.A.
Practice address
2929 Mossrock
Suite 104
San Antonio, TX 78249-5141
Phone
(210) 377-0350
Fax
(210) 377-2982
NPI assigned
Aug 29, 2007
Last updated
Oct 12, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2011

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

Authorized official

Name
Mr. Lawrence D Perry, M.A.
Title
Administrator
Phone
(210) 377-0350

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

2929 Mossrock
Suite 104
San Antonio, TX 78249-5141

Mailing address

2929 Mossrock
Suite 104
San Antonio, TX 78249-5141
Phone (210) 377-0350

Other identifiers 2

IdentifierTypeStateIssuer
152016502MedicaidTX
177732801MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050712000333 TX Part B Supplier - Clinic/Group Practice 2062448095 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Locations

2929 Mossrock
San Antonio, TX 78230
Phone (210) 349-7030

2929 Mossrock
Ste 104
San Antonio, TX 78230
Phone (210) 377-0350

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318377600000",
    "number": "1477747772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 MOSSROCK",
            "address_2": "SUITE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782495141",
            "telephone_number": "210-377-0350",
            "fax_number": "210-377-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 MOSSROCK",
            "address_2": "SUITE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782495141",
            "telephone_number": "210-377-0350",
            "fax_number": "210-377-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE L. WINTER M.D. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2011-10-12",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "210-377-0350",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152016502",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177732801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.