Individual provider Active NPI

Kimberly Stachniak

  • Pediatrics Physician
  • San Antonio, TX
National Provider Identifier
1578958237
Registry record updated Mar 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R7904 Issued in TX
Practice address
3066 E Commerce St
San Antonio, TX 78220-1013
Phone
(210) 233-7063
NPI assigned
Mar 31, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R7904 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

3066 E Commerce St
San Antonio, TX 78220-1013

Mailing address

3066 E Commerce St
San Antonio, TX 78220-1013
Phone (210) 233-7063

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
I20180822001158 TX Practitioner - Pediatric Medicine 9133478266 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Mar 3, 2025 Accepting new patients
Community Medicine Associates Pediatrics CurrentSince Aug 1, 2018 Accepting new patients
Emergency Medicine Services of TX, PLLC CurrentSince Jan 1, 2025 Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. Current Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Mar 3, 2025 Accepting new patients
Pain Management Specialists CurrentSince Feb 7, 2021 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

225 E Parkwood Ave
Friendswood, TX 77546
Phone (281) 549-9400

11100 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 770-7000

903 W Martin St
San Antonio, TX 78207
Phone (210) 358-3400

903 W Martin St
#B
San Antonio, TX 78207
Phone (210) 358-3441

1102 Barclay St
San Antonio, TX 78207
Phone (210) 434-0513

3066 E Commerce St
San Antonio, TX 78220
Phone (210) 233-7062

903 W Martin St
#492
San Antonio, TX 78207
Phone (210) 358-3441

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

14625 Huebner Rd
San Antonio, TX 78230

26306 Kuykendahl Rd
Tomball, TX 77375
Phone (346) 246-7700

Organizations & group practices 6

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": "1427760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1578958237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3066 E COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782201013",
            "telephone_number": "210-233-7063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3066 E COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782201013",
            "telephone_number": "210-233-7063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACHNIAK",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-31",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R7904",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.