Individual provider Active NPI

Adam Joseph Verrett

  • Oral and Maxillofacial Surgery (Dentist)
  • San Antonio, TX
National Provider Identifier
1871787291
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
23550 Issued in TX
Practice address
4499 Medical Dr Ste 190
San Antonio, TX 78229-3768
Phone
(210) 614-3915
Fax
(210) 614-5234
NPI assigned
Aug 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 23550 TX Primary

Addresses

Primary practice location

4499 Medical Dr Ste 190
San Antonio, TX 78229-3768

Mailing address

27402 Camino HVN
Boerne, TX 78015-4879
Phone (210) 860-0951

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
I20161012001470 TX Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 1052623931

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
The Dental School at University of Texas HSC at San Antonio, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4499 Medical Dr
Suite 190
San Antonio, TX 78229-3768

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23550TXMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1871787291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27402 CAMINO HVN",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780154879",
            "telephone_number": "210-860-0951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4499 MEDICAL DR STE 190",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293768",
            "telephone_number": "210-614-3915",
            "fax_number": "210-614-5234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERRETT",
        "first_name": "ADAM",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-29",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "23550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.