Individual provider Active NPI

Mae Anne Seachon Sepulveda, MD

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1881825719
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
Q3592 Issued in TX
Practice address
8542 Wurzbach Rd
San Antonio, TX 78240-1241
Phone
(210) 616-7300
Fax
(210) 616-7359
NPI assigned
Jul 27, 2009
Last updated
Sep 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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 Q3592 TX Primary

Addresses

Primary practice location

8542 Wurzbach Rd
San Antonio, TX 78240-1241

Mailing address

2961 Mossrock
San Antonio, TX 78230-5119
Phone (210) 731-4800

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
I20150609002194 TX Practitioner - Family Practice 7618125105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physician Primecare, IncGroup PAC ID 8628073236, 70 clinicians

Practice addresses (Care Compare)

8542 Wurzbach Rd
Physician Primecare Wurzbach
San Antonio, TX 78240-1241
Phone (210) 616-7300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q3592TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Primecare, Inc Family Medicine CurrentSince Sep 27, 2021 Accepting new patients

Locations

2911 S New Braunfels Ave
San Antonio, TX 78210
Phone (210) 377-1133

2961 Mossrock
San Antonio, TX 78230
Phone (210) 731-4800

8542 Wurzbach Rd
San Antonio, TX 78240
Phone (210) 616-7300

911 Castroville Rd
San Antonio, TX 78237
Phone (210) 436-7402

Interoperability endpoints

  • Direct secure messaging: mae.sepulveda@htmg.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1881825719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2961 MOSSROCK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782305119",
            "telephone_number": "210-731-4800",
            "fax_number": "210-731-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8542 WURZBACH RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401241",
            "telephone_number": "210-616-7300",
            "fax_number": "210-616-7359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEPULVEDA",
        "first_name": "MAE ANNE",
        "middle_name": "SEACHON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-27",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q3592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.