Pablo Ezequiel Pergola, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

K4772 Issued in TX

Practice address

1123 N Main Ave Ste 120
San Antonio, TX 78212-4738

Phone

(210) 226-2001

NPI assigned

Feb 23, 2006

Last updated

Jan 21, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

NephrologyAlso: Internal Medicine

Education

Other, 1988

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)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: pablo.pergola@ra.eclinicaldirectplus.com

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.

• Renal Associates, P.a.

  • Nephrology Physician
  • San Antonio, TX
  • NPI 1851368112
  Medicare reassignment Care Compare group
• The University of Texas Health Science Center at San Antonio

  dba UT Health San Antonio Multispecialty & Research Hospital

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1326829904
  NPD (past)

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1902872765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16620 N US HIGHWAY 281",
            "address_2": "STE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782322327",
            "telephone_number": "210-614-1231",
            "fax_number": "210-616-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 N MAIN AVE STE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782124738",
            "telephone_number": "210-226-2001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 E Quincy St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782152039",
            "country_code": "US",
            "telephone_number": "210-226-2001",
            "fax_number": "210-226-5211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERGOLA",
        "first_name": "PABLO",
        "middle_name": "EZEQUIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "K4772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046790403",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Performance Associates of South Texas (Pace Counseling Group)
• Performance Republic, PLLC
• Performance Therapeutics - San Antonio PLLC
• Performance Therapeutics - San Antonio PLLC
• Performance Therapeutics San Antonio Westover, PLLC
• Kay Pergrem
• Katarina Morgan Perguson
• Perin Gomer Suthakar MD
• Perinatal & Infertility Specialists PA (Perinatal Associates of San Antonio PA)
• Peripheral Vascular Associates, P.a.

• Nephrology Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Nephrology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.