Individual provider Active NPI

Jesus Rogelio Garcia Jacques, M.D.

  • Pediatric Critical Care Medicine Physician
  • San Antonio, TX
National Provider Identifier
1609034065
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
R4224 Issued in TX
Practice address
520 Madison Oak Dr
San Antonio, TX 78258-3913
Phone
(210) 297-4000
NPI assigned
Jun 1, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0203X R4224 TX Primary

Addresses

Primary practice location

520 Madison Oak Dr
San Antonio, TX 78258-3913

Mailing address

333 N Santa Rosa
San Antonio, TX 78207-3108

Other identifiers 2

IdentifierTypeStateIssuer
R4224OtherTXMEDICAL LICENSE
232667OtherMAMA MEDICAL LISCENCE

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
I20171004001727 TX Practitioner - Critical Care (Intensivists)Practitioner - Pediatric Medicine 3779700604 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R4224TXMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine Multi-Specialty CurrentSince Oct 1, 2017 Accepting new patients
VHS San Antonio Partners LLC Past Accepting new patients

Locations

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

520 Madison Oak Dr
San Antonio, TX 78258
Phone (210) 297-0412

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

333 N Santa Rosa
San Antonio, TX 78207
Phone (210) 704-2190

Organizations & group practices 3

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": "1212278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1609034065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SANTA ROSA",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MADISON OAK DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583913",
            "telephone_number": "210-297-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA JACQUES",
        "first_name": "JESUS",
        "middle_name": "ROGELIO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-01",
        "last_updated": "2024-02-12",
        "certification_date": "2022-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "TX",
            "license": "R4224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "R4224",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MA MEDICAL LISCENCE",
            "identifier": "232667",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.