Individual provider Active NPI

Amber Olivas

  • Audiologist
  • San Antonio, TX
National Provider Identifier
1780154294
Registry record updated Nov 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
80962 Issued in TX
Practice address
4647 Medical Dr
San Antonio, TX 78229-4403
Phone
(210) 358-4583
Fax
(210) 358-2654
NPI assigned
Nov 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 80962 TX Primary

Addresses

Primary practice location

4647 Medical Dr
San Antonio, TX 78229-4403

Mailing address

PO Box 87
San Antonio, TX 78291-0087
Phone (210) 358-9500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181214000695 TX Practitioner - Qualified Audiologist 4183969405 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acro Audiology Hearing Care CenterGroup PAC ID 0547686545, 4 clinicians

Practice addresses (Care Compare)

21031 Market RDG
Suite 2
San Antonio, TX 78258-2483
Phone (210) 239-5995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
80962TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medicine Associates CurrentSince Nov 15, 2018 Accepting new patients
Acro Audiology Hearing Care Center Audiologist CurrentSince Mar 12, 2024 Accepting new patients
Pain Management Specialists PastSince Feb 7, 2021 Accepting new patients

Locations

109 W Hornbeck Blvd
Fort Stockton, TX 79735
Phone (432) 244-4311

4647 Medical Dr
San Antonio, TX 78229
Phone (210) 358-2710

21031 Market Rdg
Ste 2
San Antonio, TX 78258
Phone (210) 239-5995

903 W Martin St
#492
San Antonio, TX 78207
Phone (210) 358-3441

Organizations & group practices 3

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": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1780154294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782910087",
            "telephone_number": "210-358-9500",
            "fax_number": "210-358-9183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4647 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294403",
            "telephone_number": "210-358-4583",
            "fax_number": "210-358-2654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVAS",
        "first_name": "AMBER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-27",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "80962",
            "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 Nov 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.