Active NPI
Erik Scott Desoucy, D.O.
- Surgery Physician
- San Antonio, TX
National Provider Identifier
1669608386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 20A11509
- Practice address
- 3551 Roger Brooke Dr
San Antonio, TX 78234-4504 - Phone
- (210) 916-1064
- NPI assigned
- Jun 9, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Aerospace Medicine Physician | 2083A0100X | 20A11509 | CA | |
| Surgery Physician | 208600000X | 20A11509 | CA | Primary |
Addresses
Primary practice location
3551 Roger Brooke Dr
San Antonio, TX 78234-4504
Mailing address
3551 Rodger Brooke Drive
Jbsa - Fort Sam Houston, TX 78234
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20A11509 | CA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569456000000",
"number": "1669608386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3551 RODGER BROOKE DRIVE",
"city": "JBSA - FORT SAM HOUSTON",
"state": "TX",
"postal_code": "78234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782344504",
"telephone_number": "210-916-1064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESOUCY",
"first_name": "ERIK",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-06-09",
"last_updated": "2019-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "2083A0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Aerospace Medicine",
"state": "CA",
"license": "20A11509",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "20A11509",
"primary": true
}
],
"identifiers": [],
"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 Sep 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.