Individual provider Active NPI

Torin Walter Karsonovich, D.O.

  • Neurological Surgery Physician
  • San Antonio, TX
National Provider Identifier
1770931297
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
125.068626 Issued in IL
Practice address
333 N Santa Rosa
San Antonio, TX 78207-3108
Phone
(210) 704-4100
NPI assigned
May 25, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 125.068626 IL Primary
Neurological Surgery Physician 207T00000X U9989 TX

Addresses

Primary practice location

333 N Santa Rosa
San Antonio, TX 78207-3108

Mailing address

1300 Franklin Ave
Ste 110
Normal, IL 61761-3799
Phone (724) 854-1193

Other practice location 1

1304 Franklin Ave
Normal, IL 61761-3558
Phone (724) 854-1193

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
I20240506001147 TX Practitioner - NeurosurgeryPractitioner - General Surgery 5193017358 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.068626ILMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baylor College of Medicine CurrentSince Jun 1, 2024 Accepting new patients

Locations

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

333 N Santa Rosa
San Antonio, TX 78207
Phone (210) 704-2190

7700 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 575-5564

Interoperability endpoints

  • Direct secure messaging: tkarsonovich503849@christushealth.direct-ci.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1464134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1770931297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 FRANKLIN AVE",
            "address_2": "STE 110",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613799",
            "telephone_number": "724-854-1193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N SANTA ROSA",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073108",
            "telephone_number": "210-704-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1304 Franklin Ave",
            "address_purpose": "LOCATION",
            "city": "Normal",
            "state": "IL",
            "postal_code": "617613558",
            "country_code": "US",
            "telephone_number": "724-854-1193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KARSONOVICH",
        "first_name": "TORIN",
        "middle_name": "WALTER",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-05-25",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "125.068626",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "U9989",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.