GASTROENTEROLOGY CLINIC OF SAN ANTONIO, P.A.
NPI 1053490631
Internal Medicine - Gastroenterology in San Antonio, TX
About Gastroenterology Clinic Of San Antonio, P.a. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GASTROENTEROLOGY CLINIC OF SAN ANTONIO, P.A. (NPI 1053490631) is a healthcare organization registered as a gastroenterology in San Antonio, Texas and active in the NPI registry since November 2006. The organization holds 2 active CLIA laboratory certificates and lists Russell Havranek, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Gastroenterology Clinic Of San Antonio, P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
12Medicare enrollment records show 12 clinicians reassign Medicare billing to Gastroenterology Clinic Of San Antonio, P.A., which bills Medicare for the services they deliver. Of these, 8 practice at this address and 10 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 2
Clinicians, nearest first (12)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA 2
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 45D2171901
Gastroenterology Research Of San Antonio · San Antonio, TXCertificate of Accreditation 45D0710307
Gastroenterology Clinic Of San Antonio · San Antonio, TXFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Gastroenterology Clinic Of San Antonio, P.A.'s NPI number?
The NPI number for Gastroenterology Clinic Of San Antonio, P.A. is 1053490631. It was assigned to this organization in the NPPES registry on November 3, 2006.
Where is Gastroenterology Clinic Of San Antonio, P.A. located?
Gastroenterology Clinic Of San Antonio, P.A. is located at 8550 Datapoint Dr Suite 200, San Antonio, TX 78229. The listed phone number is (210) 615-8308.
What is Gastroenterology Clinic Of San Antonio, P.A.'s specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.
Is Gastroenterology Clinic Of San Antonio, P.A. enrolled in Medicare?
Yes. Gastroenterology Clinic Of San Antonio, P.A. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Gastroenterology Clinic Of San Antonio, P.A.?
According to the CMS Revalidation Reassignment List (October 2026 release), 12 clinicians in 2 Medicare specialties reassign their Medicare billing to Gastroenterology Clinic Of San Antonio, P.A.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Gastroenterology (9) and Nurse Practitioner (3). Of these, 8 practice at this address and 10 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Gastroenterology Clinic Of San Antonio, P.A. hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
When was this NPI record last updated?
The NPPES record for Gastroenterology Clinic Of San Antonio, P.A. was last updated on October 29, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Gastroenterology Clinic Of San Antonio, P.a. · NPI 1053490631
Gastroenterology organization in San Antonio, Texas. Organization record, active in the CMS NPPES registry since November 3, 2006.
## Identity
- **NPI:** 1053490631 (Entity type: Organization)
- **Enumerated:** November 3, 2006
- **Primary specialty:** Internal Medicine - Gastroenterology · taxonomy 207RG0100X
- **Organization subpart:** No
- **Authorized official:** Russell Havranek, CEO
## Practice location
- **Address:** 8550 DATAPOINT DR, SUITE 200, San Antonio, TX 78229-3270
- **Phone:** (210) 615-8308 · **Fax:** (210) 615-8313
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 12 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Gastroenterology (9), Nurse Practitioner (3); 8 practice at this address and 10 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 29, 2015
- **Other identifiers:** Other 00BL45 (TX); Medicaid 044080201 (TX)
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1053490631) · Data from the CMS NPPES public registry.