Individual provider Active NPI

Stephen Greenfield, PA

  • Medical Physician Assistant
  • San Antonio, TX
National Provider Identifier
1568469203
Registry record updated Mar 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA00689 Issued in TX
Practice address
430 W Sunset Rd Ste 201
San Antonio, TX 78209-1772
Phone
(210) 824-4584
Fax
(210) 805-8466
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA00689 TX Primary

Addresses

Primary practice location

430 W Sunset Rd Ste 201
San Antonio, TX 78209-1772

Mailing address

430 W Sunset Rd Ste 201
San Antonio, TX 78209-1772
Phone (210) 824-4584

Other identifiers 2

IdentifierTypeStateIssuer
3142911-01OtherTXWELLMED MEDICAID
TXB152755OtherWELLMED MEDICAL GROUP PA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120613000723 TX Practitioner - Physician Assistant 8224292743 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA00689TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Clinic of North Texas, PLLC CurrentSince Jan 1, 2022 Accepting new patients
Medical Clinic of North Texas PLLC CurrentSince Jan 1, 2022 Accepting new patients

Locations

900 Airport Fwy
Ste 158
Hurst, TX 76054
Phone (817) 514-4000

4001 W 15th St
Ste 245
Plano, TX 75093
Phone (972) 596-5222

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1568469203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 W SUNSET RD STE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091772",
            "telephone_number": "210-824-4584",
            "fax_number": "210-805-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 W SUNSET RD STE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091772",
            "telephone_number": "210-824-4584",
            "fax_number": "210-805-8466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENFIELD",
        "first_name": "STEPHEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA00689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED MEDICAID",
            "identifier": "3142911-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED MEDICAL GROUP PA",
            "identifier": "TXB152755",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.