Organization Active NPI

Crestview Health PLLC

  • Primary Care Clinic/Center
  • San Antonio, TX
National Provider Identifier
1750846135
Registry record updated Oct 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CRESTVIEW HEALTH PLLC
Practice address
12650 Nacogdoches Rd
San Antonio, TX 78217-2118
Phone
(440) 681-0664
NPI assigned
Feb 9, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2023

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

Authorized official

Name
Dr. Christopher Ajufo, MDNPI 1811220015
Title
Owner
Phone
(440) 681-0664

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X
Clinic/Center 261Q00000X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

12650 Nacogdoches Rd
San Antonio, TX 78217-2118

Mailing address

12650 Nacogdoches Rd
San Antonio, TX 78217-2118
Phone (440) 681-0664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190717003421 TX Part B Supplier - Clinic/Group Practice 7315272002 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1549670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696723200000",
    "number": "1750846135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12650 NACOGDOCHES RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782172118",
            "telephone_number": "440-681-0664",
            "fax_number": "210-617-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12650 NACOGDOCHES RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782172118",
            "telephone_number": "440-681-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTVIEW HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-09",
        "last_updated": "2023-10-08",
        "certification_date": "2023-10-08",
        "status": "A",
        "authorized_official_last_name": "AJUFO",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-681-0664",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.