Individual provider Active NPI

Robert Jay Freeman, MD

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1861492787
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H7057 Issued in TX
Practice address
2455 NE Loop 410
Ste 100
San Antonio, TX 78217-5649
Phone
(210) 599-6000
Fax
(210) 657-5586
NPI assigned
Jul 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H7057 TX Primary

Addresses

Primary practice location

2455 NE Loop 410
Ste 100
San Antonio, TX 78217-5649

Mailing address

2455 NE Loop 410
Ste 100
San Antonio, TX 78217-5649
Phone (210) 599-6000

Other identifiers 2

IdentifierTypeStateIssuer
8G5640OtherTXWELLMED MEDICARE
1362949-10OtherTXWELLMED MEDICAID

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
I20051116000711 TX Practitioner - Family Practice 5799704946 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA Family Medicine Current Accepting new patients
Wellmed Medical Group, P.a. Family Medicine CurrentSince Jul 1, 2005 Accepting new patients
Wellmed Medical Group, P.a. Family Medicine CurrentSince Jul 1, 2005 Accepting new patients

Locations

2455 NE Loop 410
Ste 100
San Antonio, TX 78217
Phone (210) 599-6000

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

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

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": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1861492787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 NE LOOP 410",
            "address_2": "STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175649",
            "telephone_number": "210-599-6000",
            "fax_number": "210-657-5586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 NE LOOP 410",
            "address_2": "STE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175649",
            "telephone_number": "210-599-6000",
            "fax_number": "210-657-5586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "ROBERT",
        "middle_name": "JAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-22",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H7057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED MEDICARE",
            "identifier": "8G5640",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED MEDICAID",
            "identifier": "1362949-10",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.