Individual provider Active NPI

Stephen Jan Vancleave, M.D.

  • Emergency Medicine Physician
  • San Antonio, TX
National Provider Identifier
1760586358
Registry record updated Feb 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
E2909 Issued in TX
Practice address
21465 Ih 10
Suite 217-508
San Antonio, TX 78257-1159
Phone
(210) 860-2625
NPI assigned
Sep 12, 2006
Last updated
Feb 28, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X E2909 TX Primary

Addresses

Primary practice location

21465 Ih 10
Suite 217-508
San Antonio, TX 78257-1159

Mailing address

24165 Ih 10 W
Suite 217-508
San Antonio, TX 78257-1159
Phone (210) 860-2625

Other identifiers 1

IdentifierTypeStateIssuer
122901504MedicaidTX

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
I20071116000476 TX Practitioner - Emergency MedicinePractitioner - Internal Medicine 3274621776 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.86 of 100Reported as group
Quality
92.78
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E2909TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Hospitalist Services of Texas PLLC CurrentSince Oct 1, 2010 Accepting new patients
Comprehensive Hospitalist Services of Texas PLLC CurrentSince Oct 1, 2010 Accepting new patients
Third Coast Emergency Physicians Southwest PA Emergency Medicine CurrentSince Dec 1, 2019 Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Nov 1, 2024 Accepting new patients
Ucp Physicians of Central Texas, PLLC Past Accepting new patients
San Antonio Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Stephen Van Cleavemd PA Past Accepting new patients
Impact Urgent Care PastSince Sep 17, 2012 Accepting new patients
Physicians Wound Care PLLC Past Accepting new patients

Locations

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

1401 E Trinity Mills Rd
Carrollton, TX 75006
Phone (972) 810-0700

5900 Altamesa Blvd
Ft Worth, TX 76132
Phone (817) 433-9100

3100 Avenue E
Hondo, TX 78861
Phone (830) 426-7700

100 Medical Pkwy
Lakeway, TX 78738
Phone (512) 206-8100

1011 N Galloway Ave
Mesquite, TX 75149
Phone (214) 320-7000

520 E 6th St
Odessa, TX 79761
Phone (432) 332-0929

16088 San Pedro Ave
San Antonio, TX 78232
Phone (210) 402-4092

4103 N Loop 1604 W
San Antonio, TX 78249
Phone (210) 572-8415

7719 S Ih 35
San Antonio, TX 78224
Phone (210) 572-2955

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298851200000",
    "number": "1760586358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24165 IH 10 W",
            "address_2": "SUITE 217-508",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782571159",
            "telephone_number": "210-860-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21465 IH 10",
            "address_2": "SUITE 217-508",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782571159",
            "telephone_number": "210-860-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCLEAVE",
        "first_name": "STEPHEN",
        "middle_name": "JAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2011-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "E2909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122901504",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.