Individual provider Active NPI

Micah Joel Yzaguirre, ACNPC-AG

  • Critical Care Medicine Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1669353843
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
1190385 Issued in TX
Practice address
4458 Medical Dr Ste 505
San Antonio, TX 78229-3748
Phone
(210) 690-7400
NPI assigned
Sep 11, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1190385 TX
Critical Care Medicine Nurse Practitioner 363LC0200X 1190385 TX Primary

Addresses

Primary practice location

4458 Medical Dr Ste 505
San Antonio, TX 78229-3748

Mailing address

148 Fabarm LN
New Braunfels, TX 78130-5178
Phone (210) 317-5024

Other practice location 1

7700 Floyd Curl Dr
San Antonio, TX 78229-3902
Phone (210) 575-4000

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
I20250930004620 TX Practitioner - Nurse Practitioner 4082110937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10221 Centrepark Dr
Apt 1427
Houston, TX 77043-1224

4458 Medical Dr
Suite 505
San Antonio, TX 78229-3700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1190385TXMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Ips LLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

34910 Interstate 10 W
Ste 601
Boerne, TX 78006
Phone (830) 248-1207

4458 Medical Dr
Ste 505
San Antonio, TX 78229

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

1434 E Sonterra Blvd
Ste 210
San Antonio, TX 78258
Phone (210) 481-3119

1437 E Sonterra Blvd Ste 210
San Antonio, TX 78258

4499 Medical Dr
#150
San Antonio, TX 78229
Phone (210) 614-8181

4499 Medical Dr
San Antonio, TX 78229
Phone (210) 575-4325

Organizations & group practices 1

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": "1757548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1669353843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 FABARM LN",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781305178",
            "telephone_number": "210-317-5024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4458 MEDICAL DR STE 505",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293748",
            "telephone_number": "210-690-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7700 Floyd Curl Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293902",
            "country_code": "US",
            "telephone_number": "210-575-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YZAGUIRRE",
        "first_name": "MICAH",
        "middle_name": "JOEL",
        "name_prefix": "Mr.",
        "credential": "ACNPC-AG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-11",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1190385",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "TX",
            "license": "1190385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.