Individual provider Active NPI

Aditya Dave

  • Family Medicine Physician
  • Boerne, TX
National Provider Identifier
1508327685
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T8795 Issued in TX
Practice address
25723 Old Fredericksburg Rd
Boerne, TX 78015-6605
Phone
(210) 450-6800
NPI assigned
Mar 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X T8795 TX
Family Medicine Physician 207Q00000X T8795 TX Primary

Addresses

Primary practice location

25723 Old Fredericksburg Rd
Boerne, TX 78015-6605

Mailing address

25723 Old Fredericksburg Rd
Boerne, TX 78015-6605
Phone (210) 450-6800

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
I20230926002565 TX Practitioner - Family PracticePractitioner - Sports Medicine 5799139663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Texas Health Science Center at San AntonioGroup PAC ID 0042128548, 1,290 clinicians

Practice addresses (Care Compare)

25723 Old Fredericksburg Rd
Boerne, TX 78015-6605
Phone (210) 450-6810

Hospital & facility affiliations

  • Accentcare Home Health of Texas Home health agency, San Antonio, TX, CCN 679174
  • Ut Health San Antonio Multispecialty & Research Ho Hospital, San Antonio, TX, CCN 670335
  • University Health System Hospital, San Antonio, TX, CCN 450213

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T8795TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at San Antonio CurrentSince Sep 1, 2023 Accepting new patients
University of Texas Health Science Center at San Antonio Family Medicine Current Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Sep 1, 2023 Accepting new patients

Locations

25723 Old Fredericksburg Rd
Boerne, TX 78015
Phone (210) 450-6800

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

Interoperability endpoints

  • Direct secure messaging: adave40302@direct.utmsa.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1508327685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25723 OLD FREDERICKSBURG RD",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780156605",
            "telephone_number": "210-450-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25723 OLD FREDERICKSBURG RD",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780156605",
            "telephone_number": "210-450-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVE",
        "first_name": "ADITYA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-29",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TX",
            "license": "T8795",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T8795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

Verify at the official NPI Registry.