Active NPI
Samuele Michael Cicconetti, DO
- Student in an Organized Health Care Education/Training Program
- San Antonio, TX
National Provider Identifier
1629767496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 7703 Floyd Curl Dr
San Antonio, TX 78229-3901 - Phone
- (440) 251-9445
- NPI assigned
- May 5, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | V5742 | TX | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
7703 Floyd Curl Dr
San Antonio, TX 78229-3901
Mailing address
1915 Broadway St Apt 425
San Antonio, TX 78215-1154
Phone (440) 251-9445
Other practice location 1
1100 Wilford Hall Loop Bldg 4554
Jbsa Lackland, TX 78236-5638
Phone (440) 251-9445
Other practice location 2
1915 Broadway St Apt 425
San Antonio, TX 78215-1154
Phone (440) 251-9445
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| V5742 | TX | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740528000000",
"number": "1629767496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1915 BROADWAY ST APT 425",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782151154",
"telephone_number": "440-251-9445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7703 FLOYD CURL DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782293901",
"telephone_number": "440-251-9445"
}
],
"practiceLocations": [
{
"address_1": "1100 Wilford Hall Loop Bldg 4554",
"address_purpose": "LOCATION",
"city": "Jbsa Lackland",
"state": "TX",
"postal_code": "782365638",
"country_code": "US",
"telephone_number": "440-251-9445",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1915 Broadway St Apt 425",
"address_purpose": "LOCATION",
"city": "San Antonio",
"state": "TX",
"postal_code": "782151154",
"country_code": "US",
"telephone_number": "440-251-9445",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CICCONETTI",
"first_name": "SAMUELE",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-05",
"last_updated": "2025-02-26",
"certification_date": "2025-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "TX",
"license": "V5742",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.