NPIMap

Organization Active NPI

San Antonio Head & Neck Surgical Associates, P.a.

Doing business as San Antonio ENT

  • Otolaryngology Physician
  • San Antonio, TX
National Provider Identifier
1972545549
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
SAN ANTONIO HEAD & NECK SURGICAL ASSOCIATES, P.A.
Doing business as
San Antonio ENT
Practice address
4775 Hamilton Wolfe Rd Ste 1
San Antonio, TX 78229-3456
Phone
(210) 616-0283
Fax
(210) 616-0071
NPI assigned
Jun 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Authorized official

Name
Michael Bertino, M.D.
Title
President
Phone
(210) 616-0283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

4775 Hamilton Wolfe Rd Ste 1
San Antonio, TX 78229-3456

Mailing address

4775 Hamilton Wolfe Rd Ste 1
San Antonio, TX 78229-3456
Phone (210) 616-0283

Other identifiers 1

IdentifierTypeStateIssuer
093833403MedicaidTX

Other names 1

  • San Antonio ENT Doing business as

National Provider Directory

National Provider Directory

Locations

34910 Interstate 10 W
#3
Boerne, TX 78006
Phone (210) 249-4855

6704 Randolph Blvd
Live Oak, TX 78233
Phone (210) 656-9506

2833 Babcock Rd
Ste 330
San Antonio, TX 78229
Phone (210) 616-1326

21 Spurs Ln
Ste 310
San Antonio, TX 78240
Phone (210) 558-7025

2833 Babcock Rd
Ste 340
San Antonio, TX 78229
Phone (210) 616-0283

7711 Louis Pasteur Dr
Ste 605
San Antonio, TX 78229
Phone (210) 615-8332

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644537600000",
    "number": "1972545549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4775 HAMILTON WOLFE RD STE 1",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293456",
            "telephone_number": "210-616-0283",
            "fax_number": "210-616-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4775 HAMILTON WOLFE RD STE 1",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293456",
            "telephone_number": "210-616-0283",
            "fax_number": "210-616-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANTONIO HEAD & NECK SURGICAL ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A",
        "authorized_official_last_name": "BERTINO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-616-0283",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "093833403",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Antonio ENT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.