Individual provider Active NPI

Daniella Guajardo Arellano, PA-C

  • Medical Physician Assistant
  • San Antonio, TX
National Provider Identifier
1689064602
Registry record updated Jan 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA09446 Issued in TX
Practice address
1314 E Sonterra Blvd Ste 2201
San Antonio, TX 78258-4287
Phone
(210) 496-5792
Fax
(210) 496-7601
NPI assigned
Jan 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2018

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 PA09446 TX Primary

Addresses

Primary practice location

1314 E Sonterra Blvd Ste 2201
San Antonio, TX 78258-4287

Mailing address

1314 E Sonterra Blvd Ste 2201
San Antonio, TX 78258-4287
Phone (210) 496-5792

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
I20211019001731 TX Practitioner - Physician Assistant 1052709375 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dynamic Dermatology PLLCGroup PAC ID 7416287164, 3 clinicians

Practice addresses (Care Compare)

13535 Hausman Pass
Suite 104
San Antonio, TX 78249-3581
Phone (210) 951-5530

Merit-based Incentive Payment System (MIPS)

Final score
98.45 of 100Reported as group
Quality
97.73
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA09446TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Neil F Haddock MD PA Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: daniella@sonterraderm.emadirect.md

Organizations & group practices 2

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": "1422403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516665600000",
    "number": "1689064602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 E SONTERRA BLVD STE 2201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584287",
            "telephone_number": "210-496-5792",
            "fax_number": "210-496-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 E SONTERRA BLVD STE 2201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584287",
            "telephone_number": "210-496-5792",
            "fax_number": "210-496-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARELLANO",
        "first_name": "DANIELLA",
        "middle_name": "GUAJARDO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-28",
        "last_updated": "2018-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA09446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.