NPIMap

Individual provider Active NPI

Ismael Tres Sosa, MD

  • Hospitalist Physician
  • Live Oak, TX
National Provider Identifier
1689868267
Registry record updated Jun 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
N7970 Issued in TX
Practice address
12414 Judson Rd
Live Oak, TX 78233-3255
Phone
(210) 650-9669
Fax
(210) 650-0750
NPI assigned
Aug 28, 2007
Last updated
Jun 2, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X N7970 TX
Hospitalist Physician 208M00000X N7970 TX Primary

Addresses

Primary practice location

12414 Judson Rd
Live Oak, TX 78233-3255

Mailing address

8109 Fredericksburg Rd
Physician Practice Services
San Antonio, TX 78229-3311
Phone (210) 650-9669

Other identifiers 3

IdentifierTypeStateIssuer
8DL511OtherTXBCBSTX
P01136129OtherRAILROAD MEDICARE
220663303MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101028001552 TX Practitioner - Internal Medicine 4880888338 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical School at San Antonio, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kands Healthcare LLCGroup PAC ID 3577709849, 8 clinicians

Practice addresses (Care Compare)

7585 Kitty Hawk Rd
Suite 201
Converse, TX 78109-2820
Phone (210) 468-2333

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N7970TXMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
K&S Healthcare, LLC Internal Medicine CurrentSince Sep 18, 2019 Accepting new patients
Heart to Heart Hospice of San Antonio, LLC CurrentSince Oct 9, 2023 Accepting new patients
Hospitalists of South Texas, PA Hospitalist Past Accepting new patients
Childrens Critical Care Specialists PLLC Past Accepting new patients

Locations

7585 Kitty Hawk Rd
Ste 201
Converse, TX 78109
Phone (210) 403-5982

7240 Chase Oaks Blvd
Plano, TX 75025
Phone (972) 517-6300

1000 Central Pkwy N
Ste 110
San Antonio, TX 78232
Phone (210) 824-4113

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24630/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/6170/brand/1/csg/1/fhir/r4
  • Direct secure messaging: ismael.sosa.1@24630.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401667200000",
    "number": "1689868267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8109 FREDERICKSBURG RD",
            "address_2": "PHYSICIAN PRACTICE SERVICES",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293311",
            "telephone_number": "210-650-9669",
            "fax_number": "210-650-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12414 JUDSON RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782333255",
            "telephone_number": "210-650-9669",
            "fax_number": "210-650-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOSA",
        "first_name": "ISMAEL",
        "middle_name": "TRES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-28",
        "last_updated": "2014-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "N7970",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "N7970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8DL511",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01136129",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220663303",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Live Oak, TX

Sources for this page

Verify at the official NPI Registry.