Individual provider Active NPI

Carmella Deserto, MD

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1609456730
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
V2465 Issued in TX
Practice address
4306 De Zavala Rd
San Antonio, TX 78249-4590
Phone
(201) 450-9400
NPI assigned
Apr 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X V2465 TX Primary

Addresses

Primary practice location

4306 De Zavala Rd
San Antonio, TX 78249-4590

Mailing address

4306 De Zavala Rd
San Antonio, TX 78249-4590

Other practice location 1

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-4000

Other practice location 2

903 W Martin St
San Antonio, TX 78207-0903
Phone (210) 358-3400

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
I20240719003528 TX Practitioner - Family Practice 7810433315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at San Antonio, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Texas Health Science Center at San AntonioGroup PAC ID 0042128548, 1,290 clinicians

Practice addresses (Care Compare)

4306 De Zavala Rd
BLDG 1
San Antonio, TX 78249-4590
Phone (210) 450-6720

Hospital & facility affiliations

  • Ut Health San Antonio Multispecialty & Research Ho Hospital, San Antonio, TX, CCN 670335
  • University Health System Hospital, San Antonio, TX, CCN 450213

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
V2465TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at San Antonio Family Medicine Current Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Jul 3, 2024 Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Jul 3, 2024 Accepting new patients

Locations

4306 De Zavala Rd
Bldg 1
San Antonio, TX 78249
Phone (210) 450-6720

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

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

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

4306 De Zavala Rd
San Antonio, TX 78249
Phone (210) 450-6720

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.

Hospital & facility affiliations 2

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": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1609456730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4306 DE ZAVALA RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782494590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4306 DE ZAVALA RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782494590",
            "telephone_number": "201-450-9400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4502 Medical Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782294402",
            "country_code": "US",
            "telephone_number": "210-358-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "903 W Martin St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782070903",
            "country_code": "US",
            "telephone_number": "210-358-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESERTO",
        "first_name": "CARMELLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-12",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "V2465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.