Individual provider Active NPI

Robert D Parker

  • Podiatrist
  • San Marcos, TX
National Provider Identifier
1972597953
Registry record updated Dec 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1349 Issued in TX
Practice address
1305 Wonder World Dr.
Suite 201
San Marcos, TX 78666-7502
Phone
(512) 805-7787
Fax
(512) 805-7789
NPI assigned
Sep 7, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 1349 TX Primary

Addresses

Primary practice location

1305 Wonder World Dr.
Suite 201
San Marcos, TX 78666-7502

Mailing address

1305 Wonder World Dr.
Suite 201
San Marcos, TX 78666-7502
Phone (512) 805-7787

Other identifiers 2

IdentifierTypeStateIssuer
018587801MedicaidTX
10032785OtherAMERIGROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101008000477 TX Practitioner - Podiatry 3274744677 Practice locations: San Marcos, TX
O20100930011141 TX DME Supplier - Physician - Podiatry 0547471948 Practice locations: San Marcos, TX

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1305 Wonder World Dr
Suite 201
San Marcos, TX 78666-7502
Phone (512) 805-7787

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue539
Removal of nail tissue1649

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1349TXMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jairo L Bermudez MD, PA Past Accepting new patients

Organizations & group practices 1

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": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292544000000",
    "number": "1972597953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 WONDER WORLD DR.",
            "address_2": "SUITE 201",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667502",
            "telephone_number": "512-805-7787",
            "fax_number": "512-805-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 WONDER WORLD DR.",
            "address_2": "SUITE 201",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "786667502",
            "telephone_number": "512-805-7787",
            "fax_number": "512-805-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "ROBERT",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2010-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "1349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018587801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10032785",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, TX

Sources for this page

Verify at the official NPI Registry.