Individual provider Active NPI

Veronica Guajardo, AGNP-BC

  • Gerontology Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1780349761
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
1058104 Issued in TX
Practice address
122 Saint Cloud Rd
San Antonio, TX 78228-5009
Phone
(726) 240-6949
Fax
(210) 761-3397
NPI assigned
Nov 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 1058104 TX Primary
Adult Health Nurse Practitioner 363LA2200X 1058104 TX

Addresses

Primary practice location

122 Saint Cloud Rd
San Antonio, TX 78228-5009

Mailing address

6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168
Phone (407) 533-6836

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address veronica.guajardo.1@29601.direct.athenahealth.com Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230427000042 TX Practitioner - Nurse Practitioner 3779948708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

122 Saint Cloud Rd
San Antonio, TX 78228-5009
Phone (210) 764-5605

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Conviva Medical Center Management of Texas, P.a. CurrentSince Jul 8, 2024 Accepting new patients
Centerwell Senior Primary Care (SC) PC CurrentSince Jul 8, 2024 Accepting new patients

Locations

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

4700 Millenia Blvd
Ste 650
Orlando, FL 32839
Phone (407) 533-6837

260 US Highway 181 N
Floresville, TX 78114
Phone (830) 393-8222

122 Saint Cloud Rd
San Antonio, TX 78228
Phone (210) 761-3393

Interoperability endpoints

  • Direct secure messaging: veronica.guajardo.1@29601.direct.athenahealth.com

Organizations & group practices 2

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": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1780349761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168",
            "telephone_number": "407-533-6836",
            "fax_number": "407-770-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 SAINT CLOUD RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782285009",
            "telephone_number": "726-240-6949",
            "fax_number": "210-761-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUAJARDO",
        "first_name": "VERONICA",
        "credential": "AGNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-03",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1058104",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "1058104",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "veronica.guajardo.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "122 Saint Cloud Rd",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782285009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.