NPIMap

Organization Active NPI

Medical Center Ophthalmology Associates

  • Ophthalmology Physician
  • San Antonio, TX
National Provider Identifier
1659376226
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
MEDICAL CENTER OPHTHALMOLOGY ASSOCIATES
Practice address
9157 Huebner Rd
San Antonio, TX 78240-1502
Phone
(210) 697-2020
Fax
(210) 697-2026
NPI assigned
Jun 20, 2005
Last updated
Feb 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Authorized official

Name
Candice B Davis
Title
Chief Revenue Cycle Officer
Phone
(916) 990-7590

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

9157 Huebner Rd
San Antonio, TX 78240-1502

Mailing address

500 Ross St 154-0455 Box 360584
Pittsburgh, PA 15262-0001
Phone (210) 697-2020

Other identifiers 2

IdentifierTypeStateIssuer
00HV39OtherTXMEDICARE GRP B
083052302MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040925000034 TX Part B Supplier - Clinic/Group Practice 1153390398 Receives reassigned benefits from 13 practitioners
Practice locations: Del Rio, TX; San Antonio, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2023504Medical Center Ophthalmology Associates9157 Huebner Road, San Antonio, TX 78240Certificate of waiverApr 25, 2027

National Provider Directory

National Provider Directory
Tax ID family
Medical Center Ophthalmology Associates6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9730 Westover Hills Blvd
Ste 110
San Antonio, TX 78251

Interoperability endpoints

  • Direct secure messaging: ebustamante@espmcoa.intellechartdirect.net
  • Direct secure messaging: emendez@espmcoa.intellechartdirect.net
  • Direct secure messaging: sbrown@espmcoa.intellechartdirect.net
  • Direct secure messaging: vehiem@espmcoa.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1659376226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ROSS ST 154-0455 BOX 360584",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152620001",
            "telephone_number": "210-697-2020",
            "fax_number": "210-697-2026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9157 HUEBNER RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401502",
            "telephone_number": "210-697-2020",
            "fax_number": "210-697-2026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER OPHTHALMOLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-20",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CHIEF REVENUE CYCLE OFFICER",
        "authorized_official_telephone_number": "916-990-7590"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GRP B",
            "identifier": "00HV39",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "083052302",
            "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 Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.