Individual provider Active NPI

Judianne Kellaway, MD

  • Ophthalmology Physician
  • San Antonio, TX
National Provider Identifier
1689655755
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
H5714 Issued in TX
Practice address
8300 Floyd Curl Dr
San Antonio, TX 78229-3931
Phone
(210) 450-9400
Fax
(210) 450-6024
NPI assigned
Nov 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X H5714 TX Primary

Addresses

Primary practice location

8300 Floyd Curl Dr
San Antonio, TX 78229-3931

Mailing address

7703 Floyd Curl Dr
San Antonio, TX 78229-3901
Phone (210) 450-9400

Other identifiers 2

IdentifierTypeStateIssuer
134627209OtherTXCSHCN
134627208MedicaidTX

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
I20101203000533 TX Practitioner - Ophthalmology 9436243276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Texas Health Science Center at San AntonioGroup PAC ID 0042128548, 1,290 clinicians

Practice addresses (Care Compare)

8300 Floyd Curl Dr
San Antonio, TX 78229-3931
Phone (210) 450-9000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at San Antonio CurrentSince Apr 1, 2016 Accepting new patients
University of Texas Health Science Center at San Antonio Ophthalmology Current Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Apr 1, 2016 Accepting new patients
University of Texas Health Science Center at San Antonio Past Accepting new patients

Locations

8300 Floyd Curl Dr
Fl 7
San Antonio, TX 78229
Phone (210) 450-9060

701 S Zarzamora St
San Antonio, TX 78207
Phone (210) 358-7000

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

7979 Wurzbach Rd
San Antonio, TX 78229
Phone (210) 450-1000

8300 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-9300

Interoperability endpoints

  • Direct secure messaging: jkellaway24634@direct.utmsa.com

Organizations & group practices 4

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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1689655755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293901",
            "telephone_number": "210-450-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 FLOYD CURL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293931",
            "telephone_number": "210-450-9400",
            "fax_number": "210-450-6024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLAWAY",
        "first_name": "JUDIANNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-07",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "H5714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "134627209",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134627208",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.