Kevin Proud, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

Q1479 Issued in TX

Practice address

4502 Medical Dr
San Antonio, TX 78229-4402

Phone

(210) 617-5256

Fax

(210) 949-3006

NPI assigned

Jul 19, 2007

Last updated

Feb 25, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pulmonary DiseaseAlso: Critical Care (Intensivists)

Education

Loyola University of Chicago, Stritch School of Medicine, 2007

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)

Hospital & facility affiliations

• University Health System Hospital, San Antonio, TX, CCN 450213
• Ut Health San Antonio Multispecialty & Research Ho Hospital, San Antonio, TX, CCN 670335

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kproud24247@direct.utmsa.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University of Texas Health Science Center at San Antonio

  dba UT Health Physicians

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1720051717
  Medicare reassignment Care Compare group NPD
• The University of Texas Health Science Center at San Antonio

  dba UT Health San Antonio Multispecialty & Research Hospital

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1326829904
  NPD
• University of Texas Health Science Center at San Antonio

  dba UT Health Imaging

  • Diagnostic Radiology Physician
  • Boerne, TX
  • NPI 1417921834
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bexar County Hospital District

  dba University Health

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1821011248
  Care Compare affiliation
• The University of Texas Health Science Center at San Antonio

  dba UT Health San Antonio Multispecialty & Research Hospital

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1326829904
  Care Compare affiliation

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1538369434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293901",
            "telephone_number": "708-710-9314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-617-5256",
            "fax_number": "210-949-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROUD",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-19",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301090115",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q1479",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TX",
            "license": "Q1479",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OH",
            "license": "36.095321",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "Q1479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "341591101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chester Prosser Jr.
• Prosthetic Innovations Inc
• Prosthetic Science San Antonio Inc
• Prosthetic Technology Center, Inc
• Prosthetics at Home LLC
• Charles Allen Proulx, PA-C
• Steven E Prouty
• Ellyse Nicole Provencio
• Provider Care at Home LLC (Provider Care at Home)
• Providerx of San Antonio, LLC (Providerx of San Antonio)

• Pulmonary Disease Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pulmonary Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2015; 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.
• 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.