Individual provider Active NPI

Benito Gabriel Enriquez, PA-C

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1619954369
Registry record updated Mar 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA02195 Issued in TX
Practice address
530 San Pedro Ave
San Antonio, TX 78212
Phone
(210) 225-4511
Fax
(210) 225-4514
NPI assigned
Dec 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA02195 TX Primary

Addresses

Primary practice location

530 San Pedro Ave
San Antonio, TX 78212

Mailing address

2961 Mossrock
San Antonio, TX 78230-5119
Phone (210) 731-4800

Other practice location 1

215 E Quincy St
Ste 500
San Antonio, TX 78215-2034
Phone (210) 223-1600

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100125000744 TX Practitioner - Physician Assistant 1456493741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physician Primecare, IncGroup PAC ID 8628073236, 70 clinicians

Practice addresses (Care Compare)

10307 State Hwy 151
San Antonio, TX 78251-4557
Phone (210) 237-4983

11820 Bandera Rd
Suite 102
Helotes, TX 78023-4637
Phone (210) 477-7180

1910 S New Braunfels
San Antonio, TX 78210-5220
Phone (210) 532-0891

810 S E Military Dr
Physician Primecare Val Verde
San Antonio, TX 78214-2823
Phone (210) 921-4200

911 Castroville Rd
San Antonio, TX 78237-3146
Phone (210) 436-7402

Hospital & facility affiliations

  • Baptist Medical Center Hospital, San Antonio, TX, CCN 450058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: benito.enriquez@htmg.eclinicaldirectplus.com

Organizations & group practices 1

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 1

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": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1619954369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2961 MOSSROCK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782305119",
            "telephone_number": "210-731-4800",
            "fax_number": "210-731-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 SAN PEDRO AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78212",
            "telephone_number": "210-225-4511",
            "fax_number": "210-225-4514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 E Quincy St",
            "address_2": "Ste 500",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782152034",
            "country_code": "US",
            "telephone_number": "210-223-1600",
            "fax_number": "210-271-3434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENRIQUEZ",
        "first_name": "BENITO",
        "middle_name": "GABRIEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.