Individual provider Active NPI

Andrea Joy Grant-Vermont, MD

  • Pediatrics Physician
  • San Antonio, TX
National Provider Identifier
1619953676
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
N0060 Issued in TX
Practice address
4647 Medical Dr
San Antonio, TX 78229-4403
Phone
(210) 358-8144
Fax
(210) 358-8536
NPI assigned
Dec 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X N0060 TX Primary

Addresses

Primary practice location

4647 Medical Dr
San Antonio, TX 78229-4403

Mailing address

4647 Medical Dr
San Antonio, TX 78229-4403
Phone (210) 358-5510

Other practice location 1

903 W Martin St
San Antonio, TX 78207-0903
Phone (210) 358-3441

Other identifiers 1

IdentifierTypeStateIssuer
201033201MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address agrantvermont20771@uhssa.direct-ci.com Direct

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
I20090413000095 TX Practitioner - Pediatric Medicine 9234286154 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medicine Associates Pediatrics CurrentSince Jul 18, 2016 Accepting new patients
Pain Management Specialists CurrentSince Mar 4, 2021 Accepting new patients

Locations

4647 Medical Dr
San Antonio, TX 78229
Phone (210) 358-2710

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

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

Interoperability endpoints

  • Direct secure messaging: agrantvermont20771@uhssa.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1619953676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4647 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294403",
            "telephone_number": "210-358-5510",
            "fax_number": "210-358-8536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4647 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294403",
            "telephone_number": "210-358-8144",
            "fax_number": "210-358-8536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "903 W Martin St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782070903",
            "country_code": "US",
            "telephone_number": "210-358-3441",
            "fax_number": "210-358-5944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANT-VERMONT",
        "first_name": "ANDREA",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-21",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N0060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201033201",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agrantvermont20771@uhssa.direct-ci.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4647 Medical Dr",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782294403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.