Individual provider Active NPI

Justin E. Caron, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Shavano Park, TX
National Provider Identifier
1730422783
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
S0854 Issued in TX
Practice address
4085 De Zavala Rd Ste 200
Shavano Park, TX 78249-2084
Phone
(210) 558-6288
Fax
(210) 558-6289
NPI assigned
Mar 28, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X A143595 CA
Student in an Organized Health Care Education/Training Program 390200000X
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X S0854 TX Primary

Addresses

Primary practice location

4085 De Zavala Rd Ste 200
Shavano Park, TX 78249-2084

Mailing address

PO Box 681149
San Antonio, TX 78268-1149
Phone (210) 558-6288

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
I20190802000288 TX Practitioner - Pathology 2860757432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Utah School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Texas Pathology Associates LLPGroup PAC ID 6406851054, 25 clinicians

Practice addresses (Care Compare)

7700 Floyd Curl Dr
San Antonio, TX 78229-3902
Phone (210) 558-6288

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A143595CAMDAnatomic Pathology Physician
S0854TXMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Texas Pathology Associates LLP Anatomic Pathology & Clinical Pathology CurrentSince Aug 1, 2019 Accepting new patients

Locations

8026 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-8110

1139 E Sonterra Blvd
San Antonio, TX 78258
Phone (210) 638-2000

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

4085 De Zavala Rd
Shavano Park, TX 78249

4085 De Zavala Rd
Ste 200
Shavano Park, TX 78249
Phone 2105586288123

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 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": "1364428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1730422783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 681149",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782681149",
            "telephone_number": "210-558-6288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4085 DE ZAVALA RD STE 200",
            "city": "SHAVANO PARK",
            "state": "TX",
            "postal_code": "782492084",
            "telephone_number": "210-558-6288",
            "fax_number": "210-558-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARON",
        "first_name": "JUSTIN",
        "middle_name": "E.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-28",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "CA",
            "license": "A143595",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "S0854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shavano Park, TX

Sources for this page

Verify at the official NPI Registry.