Juan E Carballo, M.D
Individual provider Active NPI Pediatrics Physician · San Antonio, TX
NPI 1497983134 · NPPES record last updated Oct 15, 2024
Key facts
- NPI
- 1497983134
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- P2834 (TX)
- Practice address
- 207 E. Evergreen St.
San Antonio, TX 78218 - Phone
- (210) 223-3543
- Fax
- (210) 924-1374
- NPI assigned
- Jul 1, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 23
Medicare Care Compare profile
- Specialty
- Pediatric Medicine
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- El Centro del Barrio Inc
Practice addresses (Care Compare)
6315 S Zarzamora St
San Antonio, TX 78211-3218
Phone (210) 922-7000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190911001719 | TX | Practitioner - Pediatric Medicine | 3476882713 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P2834 | TX | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| El Centro del Barrio, Inc. | Current |
Accepting new patients | |
| El Centro del Barrio, Inc. | Current | Accepting new patients | |
| El Centro del Barrio | Current |
Accepting new patients | |
| El Centro del Barrio, Inc. | Past | Accepting new patients |
Locations
6315 S Zarzamora St
San Antonio, TX 78211
Phone (210) 924-9254
207 E Evergreen St
San Antonio, TX 78212
207 E Evergreen St
Ste 103
San Antonio, TX 78212
315 N San Saba
Ste 1075
San Antonio, TX 78207
Phone (210) 227-0282
3750 Commercial Ave
San Antonio, TX 78221
Phone (210) 334-3700
Interoperability endpoints
- juan.carballo.p1@direct.centromed.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | P2834 | TX | Yes |
Addresses
Primary practice location
207 E. Evergreen St.
San Antonio, TX 78218
Mailing address
3750 Commercial Ave
San Antonio, TX 78221-3117
Phone (210) 922-7000
Other providers in San Antonio, TX
- Christopher R. Carabin
- Francis Joseph Carabin
- Jessica Carachure
- Caraday Wurzbach LLC
- Julie Carbajal
- Eliud Carbo Ontiveros
- Anthony Carbone
- Rachel Smullen Carbone
- Carbonell Medical Clinic MD PA
- Aimee Carbonell
All providers in San Antonio, TX · Pediatrics Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.