Individual provider Active NPI

Amber M Moreno, DO

  • Pediatrics Physician
  • San Antonio, TX
National Provider Identifier
1750355848
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
M0832 Issued in TX
Practice address
8366 N Loop 1604 W
Ste 105
San Antonio, TX 78249-3533
Phone
(210) 680-6000
Fax
(210) 680-9153
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X M0832 TX Primary

Addresses

Primary practice location

8366 N Loop 1604 W
Ste 105
San Antonio, TX 78249-3533

Mailing address

333 N Santa Rosa St
Ste D4023
San Antonio, TX 78207-3108
Phone (469) 282-2711

Other identifiers 4

IdentifierTypeStateIssuer
179273105MedicaidTX
8S5060OtherTXBCBS
1750355848OtherTXNPI
179273101MedicaidTX

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
I20060126000324 TX Practitioner - Pediatric Medicine 3375557648 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas CurrentSince Jan 1, 2022 Accepting new patients
Christus Trinity Clinic Texas Pediatrics CurrentSince Jan 1, 2022 Accepting new patients
Northwest Pediatric Associates Past Accepting new patients

Locations

8366 N Loop 1604 W
Ste 105
San Antonio, TX 78249
Phone (210) 680-6000

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: amoreno282950@christushealth.direct-ci.net

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1750355848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SANTA ROSA ST",
            "address_2": "STE D4023",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073108",
            "telephone_number": "469-282-2711",
            "fax_number": "469-282-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8366 N LOOP 1604 W",
            "address_2": "STE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782493533",
            "telephone_number": "210-680-6000",
            "fax_number": "210-680-9153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "AMBER",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M0832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179273105",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8S5060",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1750355848",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179273101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.