NPIMap

Organization Active NPI

Sports Medicine Associates of San Antonio, PA

  • Orthopaedic Surgery Physician
  • San Antonio, TX
National Provider Identifier
1568280808
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SPORTS MEDICINE ASSOCIATES OF SAN ANTONIO, PA
Practice address
10622 State Highway 151 Ste 205
San Antonio, TX 78251-4729
Phone
(210) 699-8326
Fax
(210) 561-7121
NPI assigned
Sep 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Authorized official

Name
Julie Birkelo
Title
Credentialing Specialist
Phone
(210) 756-5240

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Orthopaedic Foot and Ankle Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0004X
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XX0005X
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

10622 State Highway 151 Ste 205
San Antonio, TX 78251-4729

Mailing address

PO Box 268996
Dept 1131
Oklahoma City, OK 73126
Phone (210) 699-8326

Other names 1

  • Sports Medicine Associates of San Antonio, PA Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sports Medicine Associates of San Antonio9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

120 Medical Dr
#120
Boerne, TX 78006

10622 State Highway 151
Ste 205
San Antonio, TX 78251

21 Spurs Ln
Ste 210
San Antonio, TX 78240
Phone (832) 621-0699

255 E Sonterra Blvd
Ste 204
San Antonio, TX 78258

Practitioners & affiliated clinicians

Practitioners 99

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 99

NPI Registry JSON

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

{
    "created_epoch": "1727308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1568280808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 268996",
            "address_2": "DEPT 1131",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73126",
            "telephone_number": "210-699-8326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10622 STATE HIGHWAY 151 STE 205",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782514729",
            "telephone_number": "210-699-8326",
            "fax_number": "210-561-7121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE ASSOCIATES OF SAN ANTONIO, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-26",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "BIRKELO",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "210-756-5240"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sports Medicine Associates of San Antonio, PA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sports Medicine Associates of San Antonio, PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 30, 2024; 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.