Individual provider Active NPI

Oliverio Corchado, P.A.-C

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1689649436
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA03720 Issued in TX
Practice address
19780 S US Highway 281
San Antonio, TX 78221-9761
Phone
(210) 626-0600
Fax
(210) 626-1174
NPI assigned
Feb 22, 2006
Last updated
Oct 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA03720 TX Primary

Addresses

Primary practice location

19780 S US Highway 281
San Antonio, TX 78221-9761

Mailing address

PO Box 87
San Antonio, TX 78291-0087
Phone (210) 626-0600

Other practice location 1

903 W Martin St
San Antonio, TX 78207-0903
Phone (201) 358-3441

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
I20040806000253 TX Practitioner - Physician Assistant 4284606708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medicine AssociatesGroup PAC ID 7719979509, 590 clinicians

Practice addresses (Care Compare)

4647 Medical Dr
San Antonio, TX 78229-4403
Phone (210) 358-2710

903 W Martin St
Ms 49 2
San Antonio, TX 78207-3110
Phone (210) 358-3441

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Management Specialists PastSince Feb 7, 2021 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ocorchado41305@uhssa.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1689649436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782910087",
            "telephone_number": "210-626-0600",
            "fax_number": "210-626-1174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19780 S US HIGHWAY 281",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782219761",
            "telephone_number": "210-626-0600",
            "fax_number": "210-626-1174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "903 W Martin St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782070903",
            "country_code": "US",
            "telephone_number": "201-358-3441",
            "fax_number": "210-358-5944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORCHADO",
        "first_name": "OLIVERIO",
        "name_prefix": "Mr.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA03720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.