Individual provider Active NPI

Rosalio Sanchez Jr., LSA

  • Surgical Physician Assistant
  • San Antonio, TX
National Provider Identifier
1992054415
Registry record updated Feb 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
SA00546 Issued in TX
Practice address
540 Madison Oak Dr
Ste 610
San Antonio, TX 78258-3924
Phone
(210) 352-5346
Fax
(210) 352-5367
NPI assigned
Aug 29, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X SA00546 TX Primary

Addresses

Primary practice location

540 Madison Oak Dr
Ste 610
San Antonio, TX 78258-3924

Mailing address

540 Madison Oak Dr
Ste 610
San Antonio, TX 78258-3924
Phone (210) 352-5346

Other identifiers 3

IdentifierTypeStateIssuer
SA00546OtherTXLSA LICENSE
12681733OtherTXCAQH
84BB85OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SA00546TXMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
San Antonio Surgical Assistants, Inc. 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": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517443200000",
    "number": "1992054415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 MADISON OAK DR",
            "address_2": "STE 610",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583924",
            "telephone_number": "210-352-5346",
            "fax_number": "210-352-5367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 MADISON OAK DR",
            "address_2": "STE 610",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583924",
            "telephone_number": "210-352-5346",
            "fax_number": "210-352-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "ROSALIO",
        "name_suffix": "Jr.",
        "credential": "LSA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-29",
        "last_updated": "2018-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "SA00546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LSA LICENSE",
            "identifier": "SA00546",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12681733",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "84BB85",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 1, 2018; 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.