Individual provider Active NPI

Juan Sayson Pico, D.O.

  • Internal Medicine Physician
  • Live Oak, TX
National Provider Identifier
1801846068
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
L5514 Issued in TX
Practice address
12702 N Ih 35
Live Oak, TX 78233-2609
Phone
(210) 650-9669
Fax
(210) 650-0750
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0102049959 VA
Internal Medicine Physician 207R00000X L5514 TX Primary

Addresses

Primary practice location

12702 N Ih 35
Live Oak, TX 78233-2609

Mailing address

8109 Fredericksburg Rd
Physician Practice Services
San Antonio, TX 78229-3311
Phone (210) 650-9669

Other identifiers 3

IdentifierTypeStateIssuer
213809103MedicaidTX
P01169315OtherRAILROAD MEDICARE
8DL502OtherTXBCBSTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address JUAN.PICO@hca7.eclinicaldirectplus.com

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
I20100505000488 TX Practitioner - Internal Medicine 1557499936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 1993
Medicare assignment
May accept Medicare assignment
Group practices
Pasteur Medical Associates PAGroup PAC ID 2769487701, 7 clinicians

Practice addresses (Care Compare)

4410 Medical Dr
Suite 100
San Antonio, TX 78229-3737
Phone (210) 614-4000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102049959VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pasteur Medical Associates PA Internal Medicine CurrentSince Oct 1, 2022 Accepting new patients
Northeast Internal Medical Associates PLLC Internal Medicine Past Accepting new patients

Locations

4410 Medical Dr
Ste 100
San Antonio, TX 78229
Phone (210) 614-4000

Interoperability endpoints

  • Direct secure messaging: juan.pico@hca7.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/JGHHBA

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1801846068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8109 FREDERICKSBURG RD",
            "address_2": "PHYSICIAN PRACTICE SERVICES",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293311",
            "telephone_number": "210-650-9669",
            "fax_number": "210-650-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12702 N IH 35",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782332609",
            "telephone_number": "210-650-9669",
            "fax_number": "210-650-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PICO",
        "first_name": "JUAN",
        "middle_name": "SAYSON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102049959",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "L5514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213809103",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01169315",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8DL502",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JUAN.PICO@hca7.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "12702 N Ih 35",
            "city": "Live Oak",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782332609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Live Oak, TX

Sources for this page

Verify at the official NPI Registry.