Active NPI
Charmaine D See, M.D.
- Family Medicine Physician
- Fort Sam Houston, TX
National Provider Identifier
1750497459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- S2168
- Practice address
- 3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504 - Phone
- (210) 916-3000
- Fax
- (210) 539-2075
- NPI assigned
- Aug 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036-098719 | IL | |
| Family Medicine Physician | 207Q00000X | S2168 | TX | Primary |
Addresses
Primary practice location
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Mailing address
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone (210) 539-9582
Other practice location 1
235 Remington Blvd
Suite J
Bolingbrook, IL 60440-5826
Phone (815) 730-3304
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04932056 | Other | IL | BLUE CROSS BLUE SHIELD |
| 81-0554589 | Other | IL | FEIN NUMBER |
| 137996 | Other | IL | AETNA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170406001782 | TX | Order and Referring Only - Family Practice | 4880740513 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-098719 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Complete Family Healthcare LTD | Family Medicine | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/21705/brand/1/csg/1/fhir/r4
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.
-
- Family Medicine Physician
- Joliet, IL
- NPI 1710320361
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593648000000",
"number": "1750497459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DR",
"city": "FORT SAM HOUSTON",
"state": "TX",
"postal_code": "782344504",
"telephone_number": "210-539-9582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3551 ROGER BROOKE DR",
"city": "FORT SAM HOUSTON",
"state": "TX",
"postal_code": "782344504",
"telephone_number": "210-916-3000",
"fax_number": "210-539-2075"
}
],
"practiceLocations": [
{
"address_1": "235 Remington Blvd",
"address_2": "Suite J",
"address_purpose": "LOCATION",
"city": "Bolingbrook",
"state": "IL",
"postal_code": "604405826",
"country_code": "US",
"telephone_number": "815-730-3304",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SEE",
"first_name": "CHARMAINE",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-23",
"last_updated": "2020-07-02",
"certification_date": "2020-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036-098719",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "S2168",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "04932056",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEIN NUMBER",
"identifier": "81-0554589",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "137996",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Sam Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.