John Edeen III, M.D.

Primary specialty

Pediatric Orthopaedic Surgery PhysicianTaxonomy code 207XP3100X

License

K3719 Issued in TX

Practice address

4499 Medical Dr
Suite 235
San Antonio, TX 78229-3735

Phone

(210) 692-1613

Fax

(210) 616-0290

NPI assigned

Feb 17, 2006

Last updated

Aug 22, 2011By 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 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: 416-edeen-john@direct.leadingreach.com
• FHIR API: https://api.platform.athenahealth.com/16700/brand/2/csg/1/fhir/r4
• Direct secure messaging: john.edeen@direct.lumeris.com
• Direct secure messaging: john.edeen@hca7.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.

• Magella Medical Associates Billing, Inc.

  dba Magella Medical Associates

  • Neonatal-Perinatal Medicine Physician
  • Round Rock, TX
  • NPI 1083631071
  Medicare reassignment NPD
• Methodist Physician Practices, PLLC

  • Surgery Physician
  • San Antonio, TX
  • NPI 1922252717
  Medicare reassignment NPD
• Pediatric Orthopedic Associates of San Antonio

  • Pediatric Orthopaedic Surgery Physician
  • San Antonio, TX
  • NPI 1528003076
  NPD

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313971200000",
    "number": "1972578565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4499 MEDICAL DRIVE",
            "address_2": "SUITE 235",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293712",
            "telephone_number": "210-692-1613",
            "fax_number": "210-616-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4499 MEDICAL DR",
            "address_2": "SUITE 235",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293735",
            "telephone_number": "210-692-1613",
            "fax_number": "210-616-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDEEN",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2011-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XP3100X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
            "state": "TX",
            "license": "K3719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048514602",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TPI",
            "identifier": "048514602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eddie Davis, DPM, PLLC (Alamo Family Foot & Ankle Care)
• Eddie Davis, DPM, PLLC (Alamo Family Foot & Ankle Care)
• Mistie Eddie
• Florence F Eddins-Folensbee, MD
• Kelsey Ede
• Jerome Edelson, MD
• Edelweiss Counseling Center, LLC
• Esther Edemuzor
• Eder Home Care, LLC
• Edgar Martinez (Medical Reliance Ambulance Service)

• Pediatric Orthopaedic Surgery Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pediatric Orthopaedic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.