Individual provider Active NPI

Daniel H Duffy, MD

  • Diagnostic Radiology Physician
  • Lackland a F B, TX
National Provider Identifier
1780657429
Registry record updated May 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
M0062 Issued in TX
Practice address
2200 Bergquist Dr
Attn: Credentials (CMC)
Lackland a F B, TX 78236-9908
Phone
(210) 292-5290
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Physician 207U00000X M0062 TX
Diagnostic Radiology Physician 2085R0202X M0062 TX Primary

Addresses

Primary practice location

2200 Bergquist Dr
Attn: Credentials (CMC)
Lackland a F B, TX 78236-9908

Mailing address

1125 Pheasant Run
San Antonio, TX 78253-5324

Other identifiers 2

IdentifierTypeStateIssuer
193582705MedicaidTX
193582706OtherTXCSHCN

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
I20080512000543 TX Practitioner - Nuclear MedicinePractitioner - Diagnostic Radiology 3375622640 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at San Antonio Diagnostic Radiology Current Accepting new patients
The University of Texas Health Science Center at San Antonio Diagnostic Radiology CurrentSince Feb 1, 2017 Accepting new patients
University of Texas Health Science Center at San Antonio Diagnostic Radiology CurrentSince Feb 1, 2017 Accepting new patients
University of Texas Health Science Center at San Antonio Past Accepting new patients

Locations

4940 Charles Katz
San Antonio, TX 78229
Phone (210) 450-9700

8311 Ewing Halsell Dr
Fl 1
San Antonio, TX 78229

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

7979 Wurzbach Rd
San Antonio, TX 78229
Phone (210) 450-1000

8300 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-9300

4502 Medical Dr
San Antonio, TX 78229
Phone (210) 358-3555

2121 SW 36th St
San Antonio, TX 78237
Phone (210) 358-5100

Organizations & group practices 4

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495756800000",
    "number": "1780657429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 PHEASANT RUN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782535324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BERGQUIST DR",
            "address_2": "ATTN: CREDENTIALS (CMC)",
            "city": "LACKLAND A F B",
            "state": "TX",
            "postal_code": "782369908",
            "telephone_number": "210-292-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFFY",
        "first_name": "DANIEL",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2017-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "TX",
            "license": "M0062",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "M0062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193582705",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "193582706",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lackland a F B, TX

Sources for this page

Verify at the official NPI Registry.