Active NPI
Scott M Kambiss, D.O.
- Gynecology Physician
- San Antonio, TX
National Provider Identifier
1689665846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- R3692
- Practice address
- 7400 Merton Minter St
San Antonio, TX 78229-4404 - Phone
- (210) 617-5300
- NPI assigned
- Nov 4, 2005
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2103117 | Medicaid | MA |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R3692 | TX | MD | Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New 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.
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- Worcester, MA
- NPI 1760445373
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.