NPIMap

Organization Active NPI

Wellmed Medical Group, PA

  • Internal Medicine Physician
  • San Antonio, TX
National Provider Identifier
1669778304
Registry record updated Feb 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WELLMED MEDICAL GROUP, PA
Practice address
19500 Ih 10 W
Ms 1-5030
San Antonio, TX 78257-9509
Phone
(210) 617-4706
NPI assigned
Jan 27, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2026

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

Authorized official

Name
Kristina Nyiri, RN
Title
Sr. Director License&Regulatory
Phone
(210) 850-6272

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

19500 Ih 10 W
Ms 1-5030
San Antonio, TX 78257-9509

Mailing address

19500 Ih 10 W
Ms 1-5030 Attn: License & Regulatory
San Antonio, TX 78257-9509
Phone (210) 617-4706

Other names 2

  • CareCoach Connect Doing business as
  • WellMed @ Embassy Oaks Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041105000519 TX Part B Supplier - Clinic/Group Practice 4880657386 Receives reassigned benefits from 880 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
45D2339051Carecoach Connect19500 Ih 10 West Ms 1-5030, San Antonio, TX 78257Certificate of waiverFeb 22, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 36

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1296086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770595200000",
    "number": "1669778304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19500 IH 10 W",
            "address_2": "MS 1-5030 ATTN: LICENSE & REGULATORY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782579509",
            "telephone_number": "210-617-4706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19500 IH 10 W",
            "address_2": "MS 1-5030",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782579509",
            "telephone_number": "210-617-4706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLMED MEDICAL GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-27",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A",
        "authorized_official_last_name": "NYIRI",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "SR. DIRECTOR LICENSE&REGULATORY",
        "authorized_official_telephone_number": "210-850-6272",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CareCoach Connect",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WellMed @ Embassy Oaks",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 9, 2026; 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.