Organization Active NPI

Dr Carlos Cardenas PLLC

  • Gynecology Physician
  • San Antonio, TX
National Provider Identifier
1497422984
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
DR CARLOS CARDENAS PLLC
Practice address
1303 McCullough Ave Ste 533
San Antonio, TX 78212-5607
Phone
(210) 465-5545
Fax
(210) 742-9605
NPI assigned
Aug 24, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Authorized official

Name
Virginia Gonzalez
Title
Office Manager
Phone
(210) 260-7102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X Primary

Addresses

Primary practice location

1303 McCullough Ave Ste 533
San Antonio, TX 78212-5607

Mailing address

609 Grandview PL
San Antonio, TX 78209-5417
Phone (210) 413-8890

Other names 1

  • DR C VIP Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211012000124 TX Part B Supplier - Clinic/Group Practice 4981002607 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2238628Dr Carlos Cardenas, PLLC1303 McCullough Ave, Ste 533, San Antonio, TX 78212Provider-performed microscopyOct 4, 2027

National Provider Directory

National Provider Directory

Locations

222 W Cypress St
#100
San Antonio, TX 78212

1303 McCullough Ave
Ste 533
San Antonio, TX 78212
Phone (210) 226-5229

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656979200000",
    "number": "1497422984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 GRANDVIEW PL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782095417",
            "telephone_number": "210-413-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 MCCULLOUGH AVE STE 533",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782125607",
            "telephone_number": "210-465-5545",
            "fax_number": "210-742-9605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR CARLOS CARDENAS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-24",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "210-260-7102"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DR C VIP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DR C VIP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.