Individual provider Active NPI

Rex Suresh Sanathra, D.O

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1710410568
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
S6033 Issued in TX
Practice address
8210 Callaghan Rd
San Antonio, TX 78230-4775
Phone
(210) 233-7000
Fax
(210) 348-9930
NPI assigned
Apr 8, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X S6033 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

8210 Callaghan Rd
San Antonio, TX 78230-4775

Mailing address

3066 E Commerce St
San Antonio, TX 78220-1013
Phone (210) 233-7000

Other identifiers 1

IdentifierTypeStateIssuer
411454801MedicaidTX

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
I20200420001960 TX Practitioner - Family Practice 7810327665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barrio Comprehensive Family Health Care Center,IncGroup PAC ID 1153226691, 63 clinicians

Practice addresses (Care Compare)

8210 Callaghan Rd
San Antonio, TX 78230-4775
Phone (210) 233-7000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S6033TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Apr 15, 2020 Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Apr 15, 2020 Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. Current Accepting new patients

Locations

3066 E Commerce St
San Antonio, TX 78220
Phone (210) 233-7062

8210 Callaghan Rd
San Antonio, TX 78230

1102 Barclay St
San Antonio, TX 78207
Phone (210) 434-0513

Interoperability endpoints

  • Direct secure messaging: rex.sanathra@commsa.eclinicaldirectplus.com

Organizations & group practices 3

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": "1491609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1710410568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3066 E COMMERCE ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782201013",
            "telephone_number": "210-233-7000",
            "fax_number": "210-434-1704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8210 CALLAGHAN RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782304775",
            "telephone_number": "210-233-7000",
            "fax_number": "210-348-9930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANATHRA",
        "first_name": "REX",
        "middle_name": "SURESH",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-08",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S6033",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "411454801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.