Individual provider Active NPI

Scott M Kambiss, D.O.

  • Gynecology Physician
  • San Antonio, TX
National Provider Identifier
1689665846
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
R3692 Issued in TX
Practice address
7400 Merton Minter St
San Antonio, TX 78229-4404
Phone
(210) 617-5300
NPI assigned
Nov 4, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X R3692 TX Primary
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X R3692 TX

Addresses

Primary practice location

7400 Merton Minter St
San Antonio, TX 78229-4404

Mailing address

15514 Cloud Top
San Antonio, TX 78248-1347
Phone (210) 967-3696

Other practice location 1

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone (210) 916-5337

Other practice location 2

15514 Cloud Top
San Antonio, TX 78248-1347
Phone (210) 967-3696

Other identifiers 1

IdentifierTypeStateIssuer
2103117MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R3692TXMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group Inc Past Accepting new patients

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, 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": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1689665846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15514 CLOUD TOP",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782481347",
            "telephone_number": "210-967-3696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 MERTON MINTER ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294404",
            "telephone_number": "210-617-5300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3551 Roger Brooke Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Sam Houston",
            "state": "TX",
            "postal_code": "782344504",
            "country_code": "US",
            "telephone_number": "210-916-5337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15514 Cloud Top",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782481347",
            "country_code": "US",
            "telephone_number": "210-967-3696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMBISS",
        "first_name": "SCOTT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "TX",
            "license": "R3692",
            "primary": true
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "TX",
            "license": "R3692",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2103117",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.