NPIMap

Organization Active NPI

San Antonio Extended Medical Care, Inc.

Doing business as Med Mart

  • Durable Medical Equipment & Medical Supplies
  • Eagle Pass, TX
National Provider Identifier
1518907237
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SAN ANTONIO EXTENDED MEDICAL CARE, INC.
Doing business as
Med Mart
Practice address
1080 Crown Ridge Blvd Ste 1
Eagle Pass, TX 78852-3496
Phone
(830) 757-4416
Fax
(830) 757-5550
NPI assigned
Jun 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Authorized official

Name
Carlos Barrera
Title
President
Phone
(210) 697-9933

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X TX Primary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X TX
Oxygen Equipment & Supplies (DME) 332BX2000X TX

Addresses

Primary practice location

1080 Crown Ridge Blvd Ste 1
Eagle Pass, TX 78852-3496

Mailing address

21195 W Interstate 10 Ste 1101
San Antonio, TX 78257-1675
Phone (210) 697-9933

Other identifiers 4

IdentifierTypeStateIssuer
173462601MedicaidTX
1025668OtherTXACM
173462602MedicaidTX
532247OtherTXBLUE CROSS BLUE SHIELD

Other names 1

  • Med Mart Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930011973 TX DME Supplier - Medical Supply CompanyDME Supplier - Oxygen & Equipment 9931220050 Practice locations: Eagle Pass, TX

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
San Antonio Extended Medical Care1080 Crown Ridge, Eagle Pass, TX 78852-3581(830) 757-4411 Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Blood Glucose Monitors/Supplies (Mail Order)|Gastric Suction Pumps|Hospital Beds (Electric)|Hospital Beds (Manual)|Insulin Infusion Pumps and/or Supplies|Pneumatic Compression Devices and/or Supplies|Support Surfaces: Press… Accepts assignmentParticipating since Sep 26, 2000

National Provider Directory

National Provider Directory
Tax ID family
San Antonio Extended Me4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1080 Crown Ridge Blvd
Ste 1
Eagle Pass, TX 78852
Phone (830) 757-4416

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704844800000",
    "number": "1518907237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21195 W INTERSTATE 10 STE 1101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782571675",
            "telephone_number": "210-697-9933",
            "fax_number": "210-697-8753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 CROWN RIDGE BLVD STE 1",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788523496",
            "telephone_number": "830-757-4416",
            "fax_number": "830-757-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANTONIO EXTENDED MEDICAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A",
        "authorized_official_last_name": "BARRERA",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-697-9933"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173462601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACM",
            "identifier": "1025668",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173462602",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "532247",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Med Mart",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eagle Pass, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.