Organization Active NPI

Leticia a. Cerda, MD, PA

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1760637060
Registry record updated Jan 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K1347 Issued in TX
Legal business name
LETICIA A. CERDA, MD, PA
Practice address
1202 W Bitters Rd BLDG 4
San Antonio, TX 78216-7852
Phone
(210) 599-8300
Fax
(210) 599-8853
NPI assigned
Dec 1, 2008
Last updated
Jan 5, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2009

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

Authorized official

Name
Celeste Catherine Juarez
Title
Billing Manager
Phone
(210) 492-9144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X K1347 TX Primary

Addresses

Primary practice location

1202 W Bitters Rd BLDG 4
San Antonio, TX 78216-7852

Mailing address

1202 W Bitters Rd BLDG 4
San Antonio, TX 78216-7852
Phone (210) 599-8300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090113000595 TX Part B Supplier - Clinic/Group Practice 1456414754 Receives reassigned benefits from 2 practitioners
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory
Tax ID family
Bluffivew Family Practice2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1202 W Bitters Rd
Bldg 4
San Antonio, TX 78216
Phone (210) 492-9144

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231113600000",
    "number": "1760637060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 W BITTERS RD BLDG 4",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782167852",
            "telephone_number": "210-599-8300",
            "fax_number": "210-599-8853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 W BITTERS RD BLDG 4",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782167852",
            "telephone_number": "210-599-8300",
            "fax_number": "210-599-8853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LETICIA A. CERDA, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-01",
        "last_updated": "2009-01-05",
        "status": "A",
        "authorized_official_last_name": "JUAREZ",
        "authorized_official_first_name": "CELESTE",
        "authorized_official_middle_name": "CATHERINE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "210-492-9144"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K1347",
            "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 Jan 5, 2009; 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.