NPIMap

Individual provider Active NPI

Rosa Isela Vizcarra, MD

  • Geriatric Medicine (Family Medicine) Physician
  • San Antonio, TX
National Provider Identifier
1649206087
Registry record updated Apr 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
M9722 Issued in TX
Practice address
7622 Louis Pasteur Dr
Ste 201
San Antonio, TX 78229-4037
Phone
(210) 610-3859
Fax
(210) 641-2277
NPI assigned
Jun 25, 2006
Last updated
Apr 27, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M9722 TX
Geriatric Medicine (Family Medicine) Physician 207QG0300X M9722 TX Primary

Addresses

Primary practice location

7622 Louis Pasteur Dr
Ste 201
San Antonio, TX 78229-4037

Mailing address

7622 Louis Pasteur Dr
Ste 201
San Antonio, TX 78229-4037
Phone (210) 610-3859

Other identifiers 2

IdentifierTypeStateIssuer
184189205MedicaidTX
315067YMVUOtherTXWNI

Other names 1

  • Dr. Rosa Isela Amaya Garcia Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070418000372 TX Practitioner - Geriatric MedicinePractitioner - Family Practice 4385749472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
San Antonio-MMC, P.a.Group PAC ID 9537207741, 8 clinicians

Practice addresses (Care Compare)

9969 Fredericksburg Rd
San Antonio, TX 78240-4106
Phone (210) 690-2273

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M9722TXMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
San Antonio-MMC, P.a. Family Medicine CurrentSince Jan 7, 2019 Accepting new patients
Wellmed Medical Group, PA Family Medicine Past Accepting new patients
Suncrest Hospice San Antonio LLC Family Medicine PastSince Mar 18, 2021 Accepting new patients

Locations

9969 Fredericksburg Rd
San Antonio, TX 78240
Phone (210) 344-2273

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Suncrest HospiceSan Antonio, TX, CCN 971590 Hospice Contracted Managing Employee Mar 18, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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 4

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": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493251200000",
    "number": "1649206087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7622 LOUIS PASTEUR DR",
            "address_2": "STE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294037",
            "telephone_number": "210-610-3859",
            "fax_number": "210-641-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7622 LOUIS PASTEUR DR",
            "address_2": "STE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294037",
            "telephone_number": "210-610-3859",
            "fax_number": "210-641-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIZCARRA",
        "first_name": "ROSA",
        "middle_name": "ISELA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2017-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M9722",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "M9722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "184189205",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WNI",
            "identifier": "315067YMVU",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSA",
            "last_name": "GARCIA",
            "middle_name": "ISELA AMAYA",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.