Individual provider Active NPI

Howard G. Weisbrod, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Live Oak, TX
National Provider Identifier
1578519252
Registry record updated Sep 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
L3521 Issued in TX
Practice address
12412 Judson Rd
Live Oak, TX 78233-3255
Phone
(210) 637-2013
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X L3521 TX Primary

Addresses

Primary practice location

12412 Judson Rd
Live Oak, TX 78233-3255

Mailing address

7418 John Smith
Suite 218
San Antonio, TX 78229-6020
Phone (210) 614-0959

Other identifiers 3

IdentifierTypeStateIssuer
173884101MedicaidTX
8S4891OtherTXBCBS
P00240010OtherTXMEDICARE RAILROAD

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050705000746 TX Practitioner - Pathology 9537105184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Hahneman Medical College of the Pacific, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12412 Judson Rd
Live Oak, TX 78233-3255
Phone (210) 757-8591

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85 of 100Reported as group
Quality
69.99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L3521TXMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Village Oaks Pathology Services, P.a. Anatomic Pathology & Clinical Pathology CurrentSince Mar 1, 2005 Accepting new patients
Village Oaks Pathology Services, P. a. CurrentSince Mar 1, 2005 Accepting new patients

Locations

12412 Judson Rd
Live Oak, TX 78233
Phone (210) 646-5000

7418 John Smith Dr
Ste 218
San Antonio, TX 78229
Phone (210) 614-0950

3300 Nacogdoches Rd
Ste 110
San Antonio, TX 78217
Phone (210) 646-0890

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189641600000",
    "number": "1578519252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7418 JOHN SMITH",
            "address_2": "SUITE 218",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782296020",
            "telephone_number": "210-614-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12412 JUDSON RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333255",
            "telephone_number": "210-637-2013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISBROD",
        "first_name": "HOWARD",
        "middle_name": "G.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2007-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "L3521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173884101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8S4891",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00240010",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Live Oak, TX

Sources for this page

Verify at the official NPI Registry.