Individual provider Active NPI

Peter Severino Muscillo, AU.D.

  • Audiologist
  • San Antonio, TX
National Provider Identifier
1780810937
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
7713128-4101 Issued in UT
Practice address
8410 Datapoint Dr Ste 150
San Antonio, TX 78229-4002
Phone
(210) 617-5300
NPI assigned
Jun 2, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 7713128-4101 UT Primary

Addresses

Primary practice location

8410 Datapoint Dr Ste 150
San Antonio, TX 78229-4002

Mailing address

8410 Datapoint Dr Ste 150
San Antonio, TX 78229-4002

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7713128-4101UTMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1780810937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8410 DATAPOINT DR STE 150",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8410 DATAPOINT DR STE 150",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294002",
            "telephone_number": "210-617-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSCILLO",
        "first_name": "PETER",
        "middle_name": "SEVERINO",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-02",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "UT",
            "license": "7713128-4101",
            "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 Mar 3, 2020; 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.