Russell Thomas Zepeda, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA05276 Issued in TX

Practice address

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504

Phone

(210) 916-2589

Fax

(210) 916-1359

NPI assigned

Jun 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Emergency Medicine Services of TX, PLLC

  • Emergency Medicine Physician
  • San Antonio, TX
  • NPI 1245938729
  Medicare reassignment
• R. Stefan Kiesz M.D. P.a.

  • Cardiovascular Disease Physician
  • San Antonio, TX
  • NPI 1336337880
  Medicare reassignment
• Alamo City Medical Group, PLLC

  • Family Medicine Physician
  • San Antonio, TX
  • NPI 1558354092
  NPD (past)
• BHS Physicians Network, Inc

  dba Orthopedic Performance Institute

  • Durable Medical Equipment & Medical Supplies
  • Boerne, TX
  • NPI 1730079286
  NPD (past)
• River City Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • San Antonio, TX
  • NPI 1164645297
  NPD (past)

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1518162122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-2589",
            "fax_number": "210-916-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-2589",
            "fax_number": "210-916-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEPEDA",
        "first_name": "RUSSELL",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-15",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "russell.t.zepeda.ctr@mail.mil",
            "affiliation": "N",
            "endpointDescription": "Office Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3551 Roger Brooke Dr",
            "city": "Fort Sam Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782344504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lisa Lynn Zacher, MD
• Adam Hunter Zager, MD
• Joshua Dillon Zamarripa
• William Anthony Zammarrelli III, M.D.
• Anastasiya Zemtsova
• Hannah Zertuche, LCSW
• Danielle Nicole Ziehl, M.D.
• Baruch Zobrist, PA-C
• Stephanie Nicole Zuckerman, PSYCHOLOGIST
• Alyssa Rae Zuehl, MD

• Physician Assistant in Fort Sam Houston, TX
• Providers in Fort Sam Houston, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.