Individual provider Active NPI

Hannah Mae Tabanao, NP-C

  • Adult Health Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1669739496
Registry record updated Feb 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP134796 Issued in TX
Practice address
2455 NE Loop 410 Ste 100
San Antonio, TX 78217-5650
Phone
(210) 599-6000
Fax
(210) 657-5586
NPI assigned
Apr 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP134796 TX Primary

Addresses

Primary practice location

2455 NE Loop 410 Ste 100
San Antonio, TX 78217-5650

Mailing address

2455 NE Loop 410 Ste 100
San Antonio, TX 78217-5650
Phone (210) 599-6000

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
I20180509000715 TX Practitioner - Nurse Practitioner 6507141660 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VMD Primary Providers South Hill Country Texas, PLLCGroup PAC ID 4284048646, 30 clinicians

Practice addresses (Care Compare)

8530 FM
Suite 78
Converse, TX 78109-1032
Phone (210) 436-8400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
306030NYMDTransplant Hepatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barrio Comprehensive Family Health Care Center,Inc. CurrentSince Jul 7, 2021 Accepting new patients
VMD Primary Providers South Hill Country Texas, PLLC CurrentSince Oct 1, 2023 Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. Current Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Jul 7, 2021 Accepting new patients

Locations

8530 FM 78
Converse, TX 78109
Phone (210) 662-7764

9055 Katy Fwy
Ste 200
Houston, TX 77024
Phone (346) 980-2701

1102 Barclay St
San Antonio, TX 78207
Phone (210) 434-0513

8210 Callaghan Rd
San Antonio, TX 78230

6393 Babcock Rd
#102
San Antonio, TX 78240
Phone (726) 200-1725

3066 E Commerce St
San Antonio, TX 78220
Phone (210) 233-7062

Interoperability endpoints

  • Direct secure messaging: hannah.mae.tabanao.1@13711.direct.athenahealth.com

Organizations & group practices 4

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": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518998400000",
    "number": "1669739496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 NE LOOP 410 STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175650",
            "telephone_number": "210-599-6000",
            "fax_number": "210-657-5586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 NE LOOP 410 STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175650",
            "telephone_number": "210-599-6000",
            "fax_number": "210-657-5586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABANAO",
        "first_name": "HANNAH MAE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-18",
        "last_updated": "2018-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP134796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.