Individual provider Active NPI

Christopher John Delallo, MPAS,PA-C

  • Medical Physician Assistant
  • San Antonio, TX
National Provider Identifier
1679680664
Registry record updated Mar 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA02829 Issued in TX
Practice address
4502 Medical Dr FL 2
San Antonio, TX 78229-4402
Phone
(210) 358-0265
Fax
(210) 358-8451
NPI assigned
Aug 24, 2006
Last updated
Mar 5, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA02829 TX Primary

Addresses

Primary practice location

4502 Medical Dr FL 2
San Antonio, TX 78229-4402

Mailing address

4502 Medical Dr FL 2
San Antonio, TX 78229-4402
Phone (210) 358-0265

Other identifiers 2

IdentifierTypeStateIssuer
183827802MedicaidTX
183827803OtherTXCSHCN

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
I20090504000302 TX Practitioner - Physician Assistant 7012065923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-4000

7703 Floyd Curl Dr
San Antonio, TX 78229-3901
Phone (210) 450-9000

8431 Fredericksburg Rd
San Antonio, TX 78229-3392

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA02829TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at San Antonio CurrentSince Apr 20, 2009 Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Apr 20, 2009 Accepting new patients
University of Texas Health Science Center at San Antonio Past Accepting new patients

Locations

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

414 Navarro St
Fl 11
San Antonio, TX 78205
Phone (210) 568-5600

4502 Medical Dr
Fl 2
San Antonio, TX 78229
Phone (210) 358-8144

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551744000000",
    "number": "1679680664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR FL 2",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-0265",
            "fax_number": "210-358-8451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR FL 2",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-0265",
            "fax_number": "210-358-8451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELALLO",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "MPAS,PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2019-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA02829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183827802",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "183827803",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.