NPIMap

Individual provider Active NPI

Michael Degaetano, DO

  • Nephrology Physician
  • San Antonio, TX
National Provider Identifier
1881660454
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
M1624 Issued in TX
Practice address
5620 Lone Star Pkwy # 2
San Antonio, TX 78253-2202
Phone
(210) 403-7978
Fax
(210) 680-0206
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X M1624 TX Primary

Addresses

Primary practice location

5620 Lone Star Pkwy # 2
San Antonio, TX 78253-2202

Mailing address

16620 N US Highway 281 Ste 300
San Antonio, TX 78232-2679
Phone (210) 614-1231

Other identifiers 1

IdentifierTypeStateIssuer
176166001MedicaidTX

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
I20050908001220 TX Practitioner - Nephrology 5294767331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
New York College of Osteo Medicine of New York Institute of Technology, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renal Associates, P.a.Group PAC ID 8729070628, 40 clinicians

Practice addresses (Care Compare)

5620 Lone Star Pkwy
Suite 2
San Antonio, TX 78253-2202
Phone (210) 403-7978

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: michael.degaetano@ra.eclinicaldirectplus.com

Organizations & group practices 1

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1881660454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16620 N US HIGHWAY 281 STE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782322679",
            "telephone_number": "210-614-1231",
            "fax_number": "210-499-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 LONE STAR PKWY # 2",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782532202",
            "telephone_number": "210-403-7978",
            "fax_number": "210-680-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGAETANO",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "M1624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176166001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.