Individual provider Active NPI

Mary Ramirez, MD

  • Dermatology Physician
  • San Antonio, TX
National Provider Identifier
1841686987
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
S1238 Issued in TX
Practice address
10630 Braun Rd Ste 105
San Antonio, TX 78254-2734
Phone
(210) 838-2909
Fax
(210) 905-0121
NPI assigned
Apr 14, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X S1238 TX Primary

Addresses

Primary practice location

10630 Braun Rd Ste 105
San Antonio, TX 78254-2734

Mailing address

10630 Braun Rd Ste 105
San Antonio, TX 78254-2734
Phone (210) 838-2909

Other identifiers 1

IdentifierTypeStateIssuer
4531139-01MedicaidTX

Other names 1

  • Mary Rose Former name

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
I20190430002656 TX Practitioner - Dermatology 5597079004 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Texas Tech University Health Science Center School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rose DermatologyGroup PAC ID 4587197702, 2 clinicians

Practice addresses (Care Compare)

10630 Braun Rd
Suite 106
San Antonio, TX 78254-2734
Phone (210) 838-2909

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions190
Removal or shaving of skin growth1-10
Skin biopsy85

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S1238TXMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Dermatology and Laser Specialists PLLC Dermatology CurrentSince Oct 18, 2022 Accepting new patients
Rose Dermatology Dermatology CurrentSince Sep 5, 2024 Accepting new patients
Westlake Dermatology PA Dermatology PastSince Jun 1, 2019 Accepting new patients

Locations

10630 Braun Rd
Ste 106
San Antonio, TX 78254
Phone (210) 838-2909

3320 Oakwell Ct
San Antonio, TX 78218

10630 Braun Rd
Ste 105
San Antonio, TX 78254
Phone (210) 239-9647

Interoperability endpoints

  • Direct secure messaging: dr.ramirez@txdermandlaser.emadirect.md
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: mramirez51504@direct.utmsa.com

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": "1428969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1841686987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10630 BRAUN RD STE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782542734",
            "telephone_number": "210-838-2909",
            "fax_number": "210-905-0121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10630 BRAUN RD STE 105",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782542734",
            "telephone_number": "210-838-2909",
            "fax_number": "210-905-0121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMIREZ",
        "first_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-14",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "S1238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4531139-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.