NPIMap

Individual provider Active NPI

Walter Mitini Etoh, NURSE PRACTITIONER

  • Acute Care Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1851945687
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1014388 Issued in TX
Practice address
4502 Medical Dr
San Antonio, TX 78229-4402
Phone
(210) 358-4000
Fax
(210) 358-0647
NPI assigned
Jul 30, 2019
Last updated
Mar 14, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1014388 TX
Acute Care Nurse Practitioner 363LA2100X 4704258160 MI
Acute Care Nurse Practitioner 363LA2100X 1014388 TX Primary

Addresses

Primary practice location

4502 Medical Dr
San Antonio, TX 78229-4402

Mailing address

4502 Medical Dr
San Antonio, TX 78229-4402
Phone (210) 358-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210317000673 TX Practitioner - Nurse Practitioner 2961732508 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Usacs Integrated Acute Care Services of Texas, PLLCGroup PAC ID 7618237264, 398 clinicians

Practice addresses (Care Compare)

111 Dallas St
San Antonio, TX 78205-1201
Phone (210) 297-7195

260 Cully Dr
Kerrville, TX 78028-5950
Phone (830) 258-7747

3011 W Loop 1604
San Antionio, TX 78251-3901
Phone (726) 266-7081

3333 Research PLZ
San Antonio, TX 78235-5154
Phone (210) 297-3650

7930 Floyd Curl Dr
San Antonio, TX 78229-3925
Phone (210) 297-5650

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1014388TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Questcare Matrix, PLLC Nurse Practitioner Current Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Mar 1, 2023 Accepting new patients
Questcare Matrix PLLC Nurse Practitioner CurrentSince Jun 3, 2022 Accepting new patients
Hospitalist Medicine Physicians of Texas, PLLC Nurse Practitioner CurrentSince Mar 1, 2022 Accepting new patients
Questcare Matrix, PLLC CurrentSince Jun 3, 2022 Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Mar 1, 2023 Accepting new patients
Usacs Integrated Acute Care Services of Texas, PLLC CurrentSince May 7, 2025 Accepting new patients
Sound Inpatient Physicians of Texas I, Inc CurrentSince Mar 1, 2021 Accepting new patients
Sound Inpatient Physicians of Texas I, Inc Current Accepting new patients
Cogent Healthcare of Texas, PA Nurse Practitioner CurrentSince Mar 1, 2022 Accepting new patients

Locations

3501 Mills Ave
Austin, TX 78731
Phone (512) 324-1017

550 E Ann Arbor Ave
Dallas, TX 75216
Phone (214) 376-1701

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

18951 N Memorial Dr
Humble, TX 77338
Phone (281) 319-8409

260 Cully Dr
Kerrville, TX 78028
Phone (830) 258-7323

1720 N McDonald St
McKinney, TX 75071
Phone (972) 562-7969

8300 Eldorado Pkwy
McKinney, TX 75070
Phone (972) 548-9339

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

11212 State Highway 151
San Antonio, TX 78251
Phone (210) 281-5066

2827 Babcock Rd
San Antonio, TX 78229
Phone (210) 253-9955

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

520 Madison Oak Dr
San Antonio, TX 78258
Phone (210) 297-0412

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

7930 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 297-5000

17500 W Grand Pkwy S
Sugar Land, TX 77479
Phone (281) 725-5000

2600 Saint Michael Dr
Texarkana, TX 75503
Phone (903) 614-1000

6565 Fannin St
Va Hospital, TX 77030
Phone (713) 394-6000

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1564444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1851945687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-4000",
            "fax_number": "210-358-0647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294402",
            "telephone_number": "210-358-4000",
            "fax_number": "210-358-0647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETOH",
        "first_name": "WALTER",
        "middle_name": "MITINI",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-30",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1014388",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704258160",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1014388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.