Individual provider Active NPI

Jennifer Johnson

  • Pediatric Cardiology Physician
  • San Antonio, TX
National Provider Identifier
1710141148
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
OS016443 Issued in PA
Practice address
4499 Medical Dr Ste 289
San Antonio, TX 78229-3712
Phone
(210) 614-3264
NPI assigned
Jul 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X OS016443 PA Primary

Addresses

Primary practice location

4499 Medical Dr Ste 289
San Antonio, TX 78229-3712

Mailing address

4499 Medical Dr Ste 289
San Antonio, TX 78229-3712

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
I20230120000906 TX Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Pediatric Medicine 2163574203 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Pediatric Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Physician Practices PLLCGroup PAC ID 8022171974, 176 clinicians

Practice addresses (Care Compare)

6800 I 10
Suite 100
San Antonio, TX 78201-2039
Phone (210) 575-8289

6800 W Ih
10 Suite 130
San Antonio, TX 78201-2039
Phone (210) 932-1487

7700 Floyd Curl Dr
San Antonio, TX 78229-3902
Phone (210) 575-7268

Hospital & facility affiliations

  • Methodist Hospital Hospital, San Antonio, TX, CCN 450388

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS016443PAMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Magella Medical Associates Billing, Inc. Pediatric Cardiology CurrentSince Jan 1, 2023 Accepting new patients
Methodist Physician Practices, PLLC CurrentSince Dec 15, 2024 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

3901 W 15th St
Plano, TX 75075
Phone (972) 519-1115

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

4499 Medical Dr
Ste 272
San Antonio, TX 78229
Phone (210) 614-3264

540 Madison Oak Dr
Ste 520
San Antonio, TX 78258
Phone (210) 490-0202

111 Dallas St
Fl 4
San Antonio, TX 78205
Phone (210) 297-7195

4499 Medical Dr
Ste 289
San Antonio, TX 78229
Phone (210) 614-3264

Interoperability endpoints

  • Direct secure messaging: 19813-johnson-jennifer@direct.leadingreach.com
  • Direct secure messaging: jennifer.johnson@hca7.eclinicaldirectplus.com
  • FHIR API: https://api.platform.athenahealth.com/16700/brand/2/csg/1/fhir/r4

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1710141148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4499 MEDICAL DR STE 289",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4499 MEDICAL DR STE 289",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293712",
            "telephone_number": "210-614-3264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-15",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "PA",
            "license": "OS016443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.