NPIMap

Organization Active NPI

Emergency Pediatric Physician MGMT LLC

  • Pediatric Emergency Medicine (Emergency Medicine) Physician
  • San Antonio, TX
National Provider Identifier
1508814385
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Emergency Medicine) PhysicianTaxonomy code 207PP0204X
Legal business name
EMERGENCY PEDIATRIC PHYSICIAN MGMT LLC
Practice address
520 Madison Oak
Peds - Emergency Room
San Antonio, TX 78258-3913
Phone
(210) 297-4050
NPI assigned
May 4, 2006
Last updated
Jun 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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

Authorized official

Name
Dr. James S. Potyka, MDNPI 1629062237
Title
General Partner
Phone
(210) 495-9860

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X NU Primary

Addresses

Primary practice location

520 Madison Oak
Peds - Emergency Room
San Antonio, TX 78258-3913

Mailing address

8401 Datapoint Dr
Suite 500
San Antonio, TX 78229-5907
Phone (210) 614-0180

Other identifiers 2

IdentifierTypeStateIssuer
0030MSOtherTXBCBSTX
174511901MedicaidTX

National Provider Directory

National Provider Directory

Locations

8401 Datapoint Dr
Ste 500
San Antonio, TX 78229

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1508814385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 DATAPOINT DR",
            "address_2": "SUITE 500",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295907",
            "telephone_number": "210-614-0180",
            "fax_number": "210-566-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MADISON OAK",
            "address_2": "PEDS - EMERGENCY ROOM",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583913",
            "telephone_number": "210-297-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENCY PEDIATRIC PHYSICIAN MGMT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "POTYKA",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "210-495-9860",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "0030MS",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "174511901",
            "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 Jun 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.