Shivana Tate, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

56539 Issued in CA

Practice address

136 Old San Antonio Rd Ste 406
Boerne, TX 78006-3341

Phone

(830) 331-4270

Fax

(830) 331-4218

NPI assigned

Nov 9, 2018

Sex

Female

Sole proprietor

Yes

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

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Conviva Medical Center Management of Texas, P.a.Group PAC ID 8729302278, 146 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Accentcare Home Health of Texas Home health agency, San Antonio, TX, CCN 679174

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shivana.tate.1@29601.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.

• Conviva Medical Center Management of Texas, P.a.

  • Internal Medicine Physician
  • Live Oak, TX
  • NPI 1770988990
  Medicare reassignment Care Compare group
• Centerwell Senior Primary Care (SC) PC

  dba CenterWell Senior Primary Care-Orchard Park

  • Internal Medicine Physician
  • Greenville, SC
  • NPI 1376907790
  NPD

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

• Texas Home Health Skilled Services,LP

  dba AccentCare Home Health of Texas

  • Home Health Agency
  • San Antonio, TX
  • NPI 1396968491
  Care Compare affiliation

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

{
    "created_epoch": "1541721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1487122206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 OLD SAN ANTONIO RD STE 406",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780063341",
            "telephone_number": "830-331-4270",
            "fax_number": "830-331-4218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 OLD SAN ANTONIO RD STE 406",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780063341",
            "telephone_number": "830-331-4270",
            "fax_number": "830-331-4218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "SHIVANA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-09",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI REGESTRY",
            "identifier": "1487122206",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tactical Trauma Therapy PLLC
• Rosaria Taimouri, MD
• Alethea Tamez, LMSW
• Karla De la Mata Tarricone, DPM
• Anne Tarwater, SLP
• Melinda Wales Taylor, M.A.
• Rabecca Teich, MSN, FNP-C
• Christine M Teicher, PA
• Laura Tejeda, PTA
• Amanda Templeton, LVN

• Physician Assistant in Boerne, TX
• Providers in Boerne, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.