Bayside Urology, PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

J3782 Issued in TX

Legal business name

BAYSIDE UROLOGY, PA

Practice address

2222 Morgan Ave
Ste. #112
Corpus Christi, TX 78405-1948

Phone

(361) 881-9550

Fax

(361) 881-8337

NPI assigned

Apr 25, 2007

Last updated

Feb 19, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Genny Mora

Title

Biling & Collections Manager

Phone

(361) 881-9550

Specialties & licenses 1

Addresses

Other identifiers 10

Locations

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455840000000",
    "number": "1952520033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2848",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784032848",
            "telephone_number": "361-881-9550",
            "fax_number": "361-881-8337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 MORGAN AVE",
            "address_2": "STE. #112",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784051948",
            "telephone_number": "361-881-9550",
            "fax_number": "361-881-8337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE UROLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2016-02-19",
        "status": "A",
        "authorized_official_last_name": "MORA",
        "authorized_official_first_name": "GENNY",
        "authorized_official_title_or_position": "BILING & COLLECTIONS MANAGER",
        "authorized_official_telephone_number": "361-881-9550",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "J3782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0008176005",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0024CK",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079579101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5955010",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "855163",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "340014366",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED MINE WORKERS",
            "identifier": "1533350",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1619681",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "099538301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1900172",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Bayside Therapy Associates LLC
• Kellie Bazan
• Bea Saenz,Ms,LPC
• Shari S Beams, PH.D., CCC-A
• Milton Alejandro Beato, M.D.
• Florencia Escalona Beattie, OTR

• Specialist in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.