Individual provider Active NPI

Jill Marie Bomar, FNP-BC

  • Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1629965066
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1063117 Issued in TX
Practice address
21750 Hardy Oak Blvd Ste 104
San Antonio, TX 78258-4946
Phone
(956) 969-2904
NPI assigned
Jun 19, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1063117 TX Primary

Addresses

Primary practice location

21750 Hardy Oak Blvd Ste 104
San Antonio, TX 78258-4946

Mailing address

21750 Hardy Oak Blvd Ste 104
San Antonio, TX 78258-4946

Other practice location 1

902 S Airport Dr
Weslaco, TX 78596-6644
Phone (956) 969-2904

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
I20251219000171 TX Practitioner - Nurse Practitioner 5890280606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BHS Physicians Network, IncGroup PAC ID 7315019593, 702 clinicians

Practice addresses (Care Compare)

2648 Loop
Suite 337
New Braunfels, TX 78130-8503
Phone (830) 310-3203

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1063117TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
BHS Physicians Network, Inc Family Medicine CurrentSince Dec 10, 2025 Accepting new patients
BHS Physicians Network, Inc CurrentSince Dec 10, 2025 Accepting new patients

Locations

2648 Loop 337
New Braunfels, TX 78130
Phone (830) 310-3203

3903 Wiseman Blvd
San Antonio, TX 78251
Phone (210) 681-0126

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": "1750291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1629965066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21750 HARDY OAK BLVD STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21750 HARDY OAK BLVD STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584946",
            "telephone_number": "956-969-2904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "902 S Airport Dr",
            "address_purpose": "LOCATION",
            "city": "Weslaco",
            "state": "TX",
            "postal_code": "785966644",
            "country_code": "US",
            "telephone_number": "956-969-2904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOMAR",
        "first_name": "JILL",
        "middle_name": "MARIE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-19",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1063117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.