Individual provider Active NPI

Michael Anthony Cardenas, MD

  • Surgery Physician
  • San Antonio, TX
National Provider Identifier
1649200809
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G4890 Issued in TX
Practice address
8042 Wurzbach Rd
Ste 310
San Antonio, TX 78229-3818
Phone
(210) 614-5113
Fax
(210) 616-0024
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G4890 TX
Surgery Physician 208600000X G4890 TX Primary

Addresses

Primary practice location

8042 Wurzbach Rd
Ste 310
San Antonio, TX 78229-3818

Mailing address

8122 Datapoint Dr
Ste 320
San Antonio, TX 78229-3264
Phone (210) 614-5113

Other identifiers 1

IdentifierTypeStateIssuer
118147101MedicaidTX

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G4890TXMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1649200809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8122 DATAPOINT DR",
            "address_2": "STE 320",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293264",
            "telephone_number": "210-614-5113",
            "fax_number": "210-616-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8042 WURZBACH RD",
            "address_2": "STE 310",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293818",
            "telephone_number": "210-614-5113",
            "fax_number": "210-616-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDENAS",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "G4890",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "G4890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118147101",
            "state": "TX"
        }
    ],
    "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 Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.