NPIMap

Individual provider Active NPI

Brad A. Deykin, MD

  • Emergency Medicine Physician
  • San Antonio, TX
National Provider Identifier
1770526444
Registry record updated Jul 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
M9966 Issued in TX
Practice address
10628 Culebra Rd
Suite 200
San Antonio, TX 78251-1320
Phone
(210) 520-3737
NPI assigned
Jun 13, 2006
Last updated
Jul 27, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2009

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 M9966 TX Primary

Addresses

Primary practice location

10628 Culebra Rd
Suite 200
San Antonio, TX 78251-1320

Mailing address

10628 Culebra Rd
Suite 200
San Antonio, TX 78251-1320
Phone (210) 520-3737

Other identifiers 3

IdentifierTypeStateIssuer
8BZ289OtherTXBCBSTX
8AN322OtherTXBCBSTX
199314903MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M9966TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
River City Emergency Physicians, PLLC Emergency Medicine Past Accepting new patients
Acs Emergency Physicians PA Emergency Medicine Past Accepting new patients
Alamo Urgent Care PLLC PastSince Jul 1, 2009 Accepting new patients
Third Coast Emergency Physicians Sid Peterson PA Emergency Medicine Past Accepting new patients

Organizations & group practices 5

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248652800000",
    "number": "1770526444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10628 CULEBRA RD",
            "address_2": "SUITE 200",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782511320",
            "telephone_number": "210-520-3737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10628 CULEBRA RD",
            "address_2": "SUITE 200",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782511320",
            "telephone_number": "210-520-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEYKIN",
        "first_name": "BRAD",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2009-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "M9966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8BZ289",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8AN322",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199314903",
            "state": "TX"
        }
    ],
    "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 Jul 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.