Individual provider Active NPI

Trina Denise St Ann, PA-C

  • Physician Assistant
  • Cibolo, TX
National Provider Identifier
1932259371
Registry record updated Nov 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA05785 Issued in TX
Practice address
791 FM 1103 Ste 125
Cibolo, TX 78108-3673
Phone
(218) 888-1175
Fax
(210) 888-0042
NPI assigned
Jan 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA05785 TX Primary

Addresses

Primary practice location

791 FM 1103 Ste 125
Cibolo, TX 78108-3673

Mailing address

791 FM 1103 Ste 125
Cibolo, TX 78108-3673
Phone (210) 888-1175

Other practice location 1

720 Pleasanton Rd
San Antonio, TX 78214-1306
Phone (210) 921-3800

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141208001472 TX Practitioner - Physician Assistant 7113249871 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA05785TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ucp Physicians of Central Texas, PLLC CurrentSince Dec 8, 2021 Accepting new patients
Southwest Texas Two Medical Group, PLLC Past Accepting new patients

Locations

6001 W William Cannon Dr
Ste 302
Austin, TX 78749
Phone (512) 288-3627

791 FM 1103
Ste 125
Cibolo, TX 78108
Phone (210) 888-1175

1331 Northpark Dr
Kingwood, TX 77339
Phone (281) 359-5330

1240 E Palm Valley Blvd
Round Rock, TX 78664
Phone (512) 733-9100

Interoperability endpoints

  • Direct secure messaging: trina.stannpac.p6@direct.nextcare.nextgenshare.com

Organizations & group practices 4

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573344000000",
    "number": "1932259371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "791 FM 1103 STE 125",
            "city": "CIBOLO",
            "state": "TX",
            "postal_code": "781083673",
            "telephone_number": "210-888-1175",
            "fax_number": "210-888-0042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "791 FM 1103 STE 125",
            "city": "CIBOLO",
            "state": "TX",
            "postal_code": "781083673",
            "telephone_number": "218-888-1175",
            "fax_number": "210-888-0042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 Pleasanton Rd",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782141306",
            "country_code": "US",
            "telephone_number": "210-921-3800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ST ANN",
        "first_name": "TRINA",
        "middle_name": "DENISE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-10",
        "last_updated": "2019-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cibolo, TX

Sources for this page

Verify at the official NPI Registry.