Individual provider Active NPI

Stephanie Lynn Rodriguez Pena, MD

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1710565130
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
U8580 Issued in TX
Practice address
448 Castroville Rd
San Antonio, TX 78207-5147
Phone
(210) 434-1400
Fax
(210) 431-7472
NPI assigned
Mar 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X BP10076331 TX
Family Medicine Physician 207Q00000X U8580 TX Primary

Addresses

Primary practice location

448 Castroville Rd
San Antonio, TX 78207-5147

Mailing address

448 Castroville Rd
San Antonio, TX 78207-5147
Phone (210) 434-1400

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
I20240911003446 TX Practitioner - Family Practice 9739583949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

448 Castroville Rd
San Antonio, TX 78207-5147
Phone (210) 434-1400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
U8580TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, P.a. Family Medicine CurrentSince Oct 6, 2024 Accepting new patients
Wellmed Medical Group, PA Family Medicine CurrentSince Oct 6, 2024 Accepting new patients

Locations

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

448 Castroville Rd
San Antonio, TX 78207
Phone (210) 434-1400

Interoperability endpoints

  • Direct secure messaging: stephanie.rodriguezpena@wellmed.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1710565130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "448 CASTROVILLE RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782075147",
            "telephone_number": "210-434-1400",
            "fax_number": "210-431-7472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "448 CASTROVILLE RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782075147",
            "telephone_number": "210-434-1400",
            "fax_number": "210-431-7472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ PENA",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-29",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10076331",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "U8580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.