Individual provider Active NPI

Jennifer Diane Brody, MD

  • Pulmonary Disease Physician
  • San Antonio, TX
National Provider Identifier
1609862127
Registry record updated Feb 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
M1536 Issued in TX
Practice address
1139 E Sonterra Blvd
Suite 300
San Antonio, TX 78258-4347
Phone
(210) 499-0770
Fax
(210) 499-0750
NPI assigned
Sep 20, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X M1536 TX
Critical Care Medicine (Internal Medicine) Physician 207RC0200X M1536 TX
Pulmonary Disease Physician 207RP1001X M1536 TX Primary

Addresses

Primary practice location

1139 E Sonterra Blvd
Suite 300
San Antonio, TX 78258-4347

Mailing address

1139 E Sonterra Blvd
Suite 300
San Antonio, TX 78258-4347
Phone (210) 499-0770

Other identifiers 1

IdentifierTypeStateIssuer
1995102-02MedicaidTX

Other names 1

  • Jennifer Diane Holmberg Former name

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
I20051101000300 TX Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 2567489289 Reassigns benefits to 1 organization
Practice locations: San Antonio, TX

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
University of Texas Medical School at San Antonio, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

19026 Stone Oak Pkwy
Suite 100
San Antonio, TX 78258-3226
Phone (210) 499-0770

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
63.33 of 100Reported as individual
Quality
25.7
Improvement activities
40
Cost
63.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M1536TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA Internal Medicine Past Accepting new patients
HMG Medical Group, P.a. Past Accepting new patients
David Salazar, M.D., P.a. Past Accepting new patients

Organizations & group practices 4

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422748800000",
    "number": "1609862127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1139 E SONTERRA BLVD",
            "address_2": "SUITE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584347",
            "telephone_number": "210-499-0770",
            "fax_number": "210-499-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1139 E SONTERRA BLVD",
            "address_2": "SUITE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584347",
            "telephone_number": "210-499-0770",
            "fax_number": "210-499-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODY",
        "first_name": "JENNIFER",
        "middle_name": "DIANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2015-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M1536",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TX",
            "license": "M1536",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "M1536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1995102-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "HOLMBERG",
            "middle_name": "DIANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.