Individual provider Active NPI

Gustavo Andres Gabino-Miranda, MD

  • Pulmonary Disease Physician
  • San Antonio, TX
National Provider Identifier
1972744365
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
P8903 Issued in TX
Practice address
21 Spurs LN
Ste 230B
San Antonio, TX 78240-1669
Phone
(210) 690-7400
NPI assigned
Mar 13, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X P8903 TX Primary

Addresses

Primary practice location

21 Spurs LN
Ste 230B
San Antonio, TX 78240-1669

Mailing address

4458 Medical Dr
Ste 505
San Antonio, TX 78229-3748
Phone (210) 690-7400

Other identifiers 1

IdentifierTypeStateIssuer
339466001MedicaidTX

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20141015001462 TX Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 4082835152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Ips LLCGroup PAC ID 9638356801, 44 clinicians

Practice addresses (Care Compare)

1434 E Sonterra Blvd
Suite 210
San Antonio, TX 78258-4973
Phone (210) 690-7400

34910 Interstate 10 W 601
Boerne, TX 78006-9230
Phone (830) 248-1207

4458 Medical Dr
Suite 505
San Antonio, TX 78229-3748
Phone (210) 690-7400

4499 Medical Dr
Suite 150
San Antonio, TX 78229-3735
Phone (210) 690-7400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
72.85 of 100Reported as individual
Quality
79.43
Improvement activities
0
Cost
75.12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P8903TXMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Ips LLC Pulmonary Disease CurrentSince Jul 1, 2014 Accepting new patients

Locations

34910 Interstate 10 W
Boerne, TX 78006
Phone (210) 396-7609

34910 Interstate 10 W
Ste 601
Boerne, TX 78006
Phone (830) 248-1207

21 Spurs Ln
Ste 230B
San Antonio, TX 78240

1434 E Sonterra Blvd
Ste 210
San Antonio, TX 78258
Phone (210) 481-3119

4499 Medical Dr
#150
San Antonio, TX 78229
Phone (210) 614-8181

4458 Medical Dr
Ste 505
San Antonio, TX 78229

4499 Medical Dr
Ste 150
San Antonio, TX 78229
Phone (210) 614-8181

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1972744365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4458 MEDICAL DR",
            "address_2": "STE 505",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293748",
            "telephone_number": "210-690-7400",
            "fax_number": "210-690-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SPURS LN",
            "address_2": "STE 230B",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401669",
            "telephone_number": "210-690-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GABINO-MIRANDA",
        "first_name": "GUSTAVO",
        "middle_name": "ANDRES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-13",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": "P8903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "339466001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.