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MARICELA A MAZUCA PA
NPI 1770582173
Physician Assistant - Medical in San Antonio, TX

Active since July 18, 2005Opted out of Medicare · through Oct 1, 2026
1202 E. SONTERRA BLVD SUITE 102, SAN ANTONIO, TX 78258(210) 271-3203(210) 733-6983 Get Directions Write a Review

NPPES record last updated: January 15, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Maricela A Mazuca Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARICELA A MAZUCA PA (NPI 1770582173) is an individual medical provider in San Antonio, Texas, licensed in Texas (PA03610) and active in the NPI registry since July 2005. She has opted out of Medicare through October 1, 2026.

NPPES Registry Identity

NPI1770582173
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMARICELA A MAZUCACredential: PA
Location Address1202 E. SONTERRA BLVD SUITE 102San Antonio, TX 78258
Mailing Address1202 E. Sonterra Blvd Suite 102San Antonio, TX 78258 · (210) 305-5075 · Fax (830) 730-5082
Phone(210) 271-3203
Fax(210) 733-6983
Sole ProprietorNo
Enumeration DateJuly 18, 2005
Last NPPES UpdateJanuary 15, 2020
✔ NPI 1770582173 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in TX · PA03610
1202 E. SONTERRA BLVD SUITE 102, San Antonio, TX 78258
Open in Google Maps ↗

Other Identifiers 1

Other8N4388TX · Bcbs

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Maricela A Mazuca Pa has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2024 through October 1, 2026.

Opt-Out Effective DateOctober 1, 2024
Opt-Out In Effect ThroughOctober 1, 2026Opt-out affidavits renew automatically every two years unless cancelled

Frequently 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 Maricela Mazuca's NPI number?

The NPI number for Maricela Mazuca is 1770582173. It was assigned to this individual provider in the NPPES registry on July 18, 2005.

Where is Maricela Mazuca located?

Maricela Mazuca practices at 1202 E. Sonterra Blvd Suite 102, San Antonio, TX 78258. The listed phone number is (210) 271-3203.

What is Maricela Mazuca's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Maricela Mazuca enrolled in Medicare?

No. Maricela Mazuca has opted out of Medicare through October 1, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Maricela Mazuca was last updated on January 15, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.