Individual provider Active NPI

Thomas Ebanja, MD

  • Anesthesiology Physician
  • San Antonio, TX
National Provider Identifier
1629654314
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
V8611 Issued in TX
Practice address
1310 McCullough Ave
San Antonio, TX 78212-5601
Phone
(212) 757-2200
NPI assigned
Mar 22, 2021
Last updated
Sep 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X V8611 TX Primary

Addresses

Primary practice location

1310 McCullough Ave
San Antonio, TX 78212-5601

Mailing address

5900 Balcones Dr Ste 100
Austin, TX 78731-4298
Phone (570) 867-0773

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
I20250818004323 TX Practitioner - Anesthesiology 5193224947 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Rutgers New Jersey Medical School, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ad of Texas PLLCGroup PAC ID 5294171823, 26 clinicians
Lone Star Anesthesia Partners PLLCGroup PAC ID 4880072636, 58 clinicians

Practice addresses (Care Compare)

135 Bunton Creek Rd
Suite 201
Kyle, TX 78640-5701
Phone (888) 851-4642

423 Treeline Park
Suite 202
San Antonio, TX 78209-2078
Phone (910) 949-6000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lone Star Anesthesia Partners PLLC Single Specialty CurrentSince Jul 15, 2025 Accepting new patients
Ad of Texas PLLC Single Specialty CurrentSince Jun 27, 2025 Accepting new patients

Locations

6421 Saratoga Blvd
Bldg 105
Corpus Christi, TX 78414
Phone (361) 985-9300

135 Bunton Creek Rd
Ste 201
Kyle, TX 78640
Phone (512) 314-5438

1310 McCullough Ave
San Antonio, TX 78212
Phone (210) 208-2200

423 Treeline Park
Ste 202
San Antonio, TX 78209
Phone (910) 949-6000

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 3

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": "1616371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1629654314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DR STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314298",
            "telephone_number": "570-867-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 MCCULLOUGH AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782125601",
            "telephone_number": "212-757-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBANJA",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-22",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "V8611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.