Methodist Medical Center ASC LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

007852 Issued in TX

Legal business name

METHODIST MEDICAL CENTER ASC LP

Doing business as

Methodist Ambulatory Surgery Center Medical Center

Practice address

4411 Medical Dr
San Antonio, TX 78229-3822

Phone

(210) 575-4584

Fax

(210) 575-4521

NPI assigned

Mar 7, 2006

Last updated

Aug 22, 2020By 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

Mr. Timothy A Carr

Title

Chief Financial Officer

Phone

(210) 575-0238

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Methodist Ambulatory Surgery Center Medical Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Methodist Medical Center ASC LPCCN 45C0001371

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Methodist Healthcare System of San Antonio, LTD., L.L.P.

  dba Methodist Specialty and Transplant Hospital

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1952348021

  Member Of

  NPD member

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Barry R Cofer, M.D.

  • Pediatric Surgery Physician
  • San Antonio, TX
  • NPI 1386617876
  NPD (past)
• Roy J Elizondo Jr., M.D.

  • Obstetrics & Gynecology Physician
  • San Antonio, TX
  • NPI 1679598981
  NPD (past)

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972570117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4411 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293822",
            "telephone_number": "210-575-4584",
            "fax_number": "210-575-4521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293822",
            "telephone_number": "210-575-4584",
            "fax_number": "210-575-4521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST MEDICAL CENTER ASC LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARR",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "210-575-0238",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "007852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "HH031A",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Methodist Ambulatory Surgery Center Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Methodist Healthcare System of San Antonio, LTD., LLP (Methodist ER City Base, a department of Methodist Hospital)
• Methodist Healthcare System of San Antonio, LTD., LLP
• Methodist Healthcare System of San Antonio, LTD., LLP (Methodist ER Legacy Trails, a department of Methodist Hospital)
• Methodist Hospital Based Physicians PLLC
• Methodist Inpatient Management Group
• Methodist Medical Group, PLLC
• Methodist Mission Home (Providence Place)
• Methodist Mission Home
• Methodist Physician Practices, PLLC
• Cristina Angela Metildi, M.D

• Ambulatory Surgical Clinic/Center in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.