Individual provider Active NPI

Stephen Gill, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Shavano Park, TX
National Provider Identifier
1619940699
Registry record updated Nov 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
25957 Issued in AZ
Practice address
4085 De Zavala Rd Ste 200
Shavano Park, TX 78249-2084
Phone
(210) 558-6288
Fax
(210) 558-6289
NPI assigned
Feb 9, 2006
Last updated
Nov 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X N0044 TX
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 25957 AZ Primary

Addresses

Primary practice location

4085 De Zavala Rd Ste 200
Shavano Park, TX 78249-2084

Mailing address

PO Box 681149
San Antonio, TX 78268-1149
Phone (210) 558-6288

Other identifiers 1

IdentifierTypeStateIssuer
210060401MedicaidTX

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
I20100126000785 TX Practitioner - Pathology 3173665346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Texas Pathology Associates LLPGroup PAC ID 6406851054, 25 clinicians

Practice addresses (Care Compare)

1139 E Sonterra Blvd
Pathology Department
San Antonio, TX 78258-3999
Phone (210) 558-6288

4085 De Zavala Rd
Shavano Park, TX 78249-2084
Phone (210) 558-6288

7700 Floyd Curl Dr
San Antonio, TX 78229-3902
Phone (210) 558-6288

8026 Floyd Curl Dr
San Antonio, TX 78229-3915
Phone (210) 558-6288

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25957AZMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Texas Pathology Associates LLP Anatomic Pathology & Clinical Pathology CurrentSince Nov 22, 2009 Accepting new patients
Apexmed, PLLC Past Accepting new patients

Locations

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

4085 De Zavala Rd
Shavano Park, TX 78249

4085 De Zavala Rd
Ste 200
Shavano Park, TX 78249
Phone 2105586288123

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731801600000",
    "number": "1619940699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 681149",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782681149",
            "telephone_number": "210-558-6288",
            "fax_number": "210-558-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4085 DE ZAVALA RD STE 200",
            "city": "SHAVANO PARK",
            "state": "TX",
            "postal_code": "782492084",
            "telephone_number": "210-558-6288",
            "fax_number": "210-558-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "STEPHEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2024-11-17",
        "certification_date": "2024-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "TX",
            "license": "N0044",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AZ",
            "license": "25957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210060401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shavano Park, TX

Sources for this page

Verify at the official NPI Registry.