Individual provider Active NPI

Derek Andrew Mathis, M.D.

  • Neuropathology Physician
  • San Antonio, TX
National Provider Identifier
1679796544
Registry record updated Nov 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuropathology PhysicianTaxonomy code 207ZN0500X
License
N1391 Issued in TX
Practice address
7700 Floyd Curl Dr
San Antonio, TX 78229-3902
Phone
(210) 575-4000
Fax
(210) 575-6059
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD 025469 LA
Neuropathology Physician 207ZN0500X N1391 TX Primary

Addresses

Primary practice location

7700 Floyd Curl Dr
San Antonio, TX 78229-3902

Mailing address

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

Other practice location 1

3551 Roger Brooke Dr
Jbsa Ft Sam Houston, TX 78234-4504
Phone (210) 916-4029

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190712002106 TX Practitioner - Pathology 6103196761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Eastern Virginia Medical School, 1999
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

  • Methodist Hospital Stone Oak Hospital, San Antonio, TX, CCN 670055
  • Methodist Hospital Hospital, San Antonio, TX, CCN 450388

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N1391TXMDNeuropathology Physician
MD 025469LAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Texas Pathology Associates LLP Anatomic Pathology & Clinical Pathology CurrentSince Jun 1, 2019 Accepting new patients

Locations

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

1139 E Sonterra Blvd
San Antonio, TX 78258
Phone (210) 638-2000

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

4085 De Zavala Rd
Shavano Park, TX 78249

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 4

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731801600000",
    "number": "1679796544",
    "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",
            "fax_number": "210-558-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 FLOYD CURL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293902",
            "telephone_number": "210-575-4000",
            "fax_number": "210-575-6059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3551 Roger Brooke Dr",
            "address_purpose": "LOCATION",
            "city": "Jbsa Ft Sam Houston",
            "state": "TX",
            "postal_code": "782344504",
            "country_code": "US",
            "telephone_number": "210-916-4029",
            "fax_number": "210-916-3235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "DEREK",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2024-11-17",
        "certification_date": "2024-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "LA",
            "license": "MD 025469",
            "primary": false
        },
        {
            "code": "207ZN0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Neuropathology",
            "state": "TX",
            "license": "N1391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.