CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS, P.A.
NPI 1770988990
Internal Medicine in Live Oak, TX

NPI Status: Active since October 30, 2014

Contact Information

12602 TOEPPERWEIN RD STE 100
LIVE OAK, TX
ZIP 78233
Phone: (210) 654-0030
Fax: (855) 278-4550

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  • Organization
  • Internal Medicine
  • CLIA Number: 45D1029017
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-08-2026

About CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS, P.A.

This page provides the complete NPI Profile along with additional information for Conviva Medical Center Management Of Texas, P.a., an internist established in Live Oak, Texas operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1770988990 assigned on October 2014. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Conviva Medical Center Management Of Texas, P.a. operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Jessica Bonetti (Associate Director)

NPI
1770988990
Provider Name
CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS, P.A.
Entity Type
Organization
Location Address
12602 TOEPPERWEIN RD STE 100 LIVE OAK, TX 78233
Location Phone
(210) 654-0030
Location Fax
(855) 278-4550
Mailing Address
6101 BLUE LAGOON DR STE 200 MIAMI, FL 33126
Mailing Phone
(305) 500-2000
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
10-30-2014
Last Update Date
06-21-2024
Code Navigator

An internist like Conviva Medical Center Management Of Texas, P.a. is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Secondary Locations

  • 12602 Toepperwein Rd Ste 100
    Live Oak, TX 78233
    (210) 654-0030

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

 
2208D00000XAllopathic & Osteopathic Physicians

General Practice

 
3261QP2300XAmbulatory Health Care Facilities

Clinic/Center
Primary Care

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JESSICA BONETTI

Authorized Official Title
ASSOCIATE DIRECTOR
Authorized Official Phone
(786) 507-8556

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
350315301MEDICAID (05)TX 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
45D1029017
Facility Type
Physician Office
Certificate Effective Date
August 09, 2024
Certificate Expiration Date
August 08, 2026
Laboratory Director
FAHD ALNORI M. ALMOHID
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Conviva Medical Center Management Of Texas, P.a. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS, P.A.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1770988990, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 80. The final step is to find the difference between that total and the next multiple of ten (80 - 80 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
0
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
8
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
9
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 9 → 18 → 9 8 → 16 → 7 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 4 + 0 + 1 + 8 + 8 + 1 + 6 + 9 + 1 + 8 + 24 = 80

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 80 is 80. The difference is the calculated check digit.

80 - 80 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1770988990.

Other Providers at the Same Location


The following 7 providers are registered at the same or a nearby location.

Pharmacist
12602 TOEPPERWEIN RD STE 100
LIVE OAK, TX 78233
Internal Medicine
12602 TOEPPERWEIN RD STE 100
LIVE OAK, TX 78233
Internal Medicine (Geriatric Medicine)
12602 TOEPPERWEIN RD STE 100
LIVE OAK, TX 78233
Physician Assistant
12602 TOEPPERWEIN RD STE 100
LIVE OAK, TX 78233
Internal Medicine
12602 TOEPPERWEIN RD STE 100
LIVE OAK, TX 78233
Nurse Practitioner (Family)
12602 TOEPPERWEIN RD STE 100
LIVE OAK, TX 78233
Family Medicine
12602 TOEPPERWEIN RD STE 100
LIVE OAK, TX 78233

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1770988990, enumerated as an "organization" on October 30, 2014.

The provider is located at 12602 TOEPPERWEIN RD STE 100 LIVE OAK, TX 78233 and the phone number is (210) 654-0030.

Internal Medicine with taxonomy code 207R00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.