NPIMap

Individual provider Active NPI

Jason David Kendelhardt, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Fort Sam Houston, TX
National Provider Identifier
1669462388
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
01056085A Issued in IN
Practice address
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone
(210) 916-5951
NPI assigned
Oct 25, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 01056085A IN Primary

Addresses

Primary practice location

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504

Mailing address

PO Box 681149
San Antonio, TX 78268-1149
Phone (210) 558-6288

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
I20230411000111 TX Practitioner - Pathology 7911195375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Duke University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Texas Pathology Associates LLPGroup PAC ID 6406851054, 25 clinicians

Practice addresses (Care Compare)

7700 Floyd Curl Dr
San Antonio, TX 78229-3902
Phone (210) 558-6288

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Texas Pathology Associates LLP Anatomic Pathology & Clinical Pathology CurrentSince Mar 1, 2023 Accepting new patients

Locations

8026 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-8110

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

4085 De Zavala Rd
Shavano Park, TX 78249

4085 De Zavala Rd
Ste 200
Shavano Park, TX 78249
Phone 2105586288123

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1669462388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 681149",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782681149",
            "telephone_number": "210-558-6288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-5951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDELHARDT",
        "first_name": "JASON",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "01056085A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.