CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS, P.A.
NPI 1770988990
Internal Medicine in Live Oak, TX
About Conviva Medical Center Management Of Texas, P.a. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS, P.A. (NPI 1770988990) is a healthcare organization registered as an internal medicine in Live Oak, Texas and active in the NPI registry since October 2014. The organization holds a CLIA Waiver certificate valid through August 8, 2028, maintains a secondary practice location in Live Oak, and lists Jessica Bonetti, Associate Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Secondary Practice Location 1
Other Identifiers 1
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)
Conviva Medical Center Management Of Texas, P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
160Medicare enrollment records show 160 clinicians reassign Medicare billing to Conviva Medical Center Management Of Texas, P.A., which bills Medicare for the services they deliver. Of these, 4 practice at this address and 21 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 7
Nearest to this location (20)
See all 160Source: 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
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 45D1029017
Conviva Medical Center Management Of Texas, PA Dba Conviva Care Center · 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 Conviva Medical Center Management Of Texas, P.A.'s NPI number?
The NPI number for Conviva Medical Center Management Of Texas, P.A. is 1770988990. It was assigned to this organization in the NPPES registry on October 30, 2014.
Where is Conviva Medical Center Management Of Texas, P.A. located?
Conviva Medical Center Management Of Texas, P.A. is located at 12602 Toepperwein Rd Ste 100, Live Oak, TX 78233. The listed phone number is (210) 654-0030.
What is Conviva Medical Center Management Of Texas, P.A.'s specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Conviva Medical Center Management Of Texas, P.A. enrolled in Medicare?
Yes. Conviva Medical Center Management Of Texas, P.A. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Conviva Medical Center Management Of Texas, P.A.?
According to the CMS Revalidation Reassignment List (October 2026 release), 160 clinicians in 7 Medicare specialties reassign their Medicare billing to Conviva Medical Center Management Of Texas, 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 Nurse Practitioner (73), Family Practice (42) and Internal Medicine (29). Of these, 4 practice at this address and 21 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Conviva Medical Center Management Of Texas, P.A. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 45D1029017) is associated with this NPI, valid through August 8, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Conviva Medical Center Management Of Texas, P.A. was last updated on June 21, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Conviva Medical Center Management Of Texas, P.a. · NPI 1770988990
Internal Medicine organization in Live Oak, Texas. Organization record, active in the CMS NPPES registry since October 30, 2014.
## Identity
- **NPI:** 1770988990 (Entity type: Organization)
- **Enumerated:** October 30, 2014
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Jessica Bonetti, ASSOCIATE DIRECTOR
## Practice location
- **Address:** 12602 TOEPPERWEIN RD STE 100, Live Oak, TX 78233-3204
- **Phone:** (210) 654-0030 · **Fax:** (855) 278-4550
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 160 clinicians in 7 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (73), Family Practice (42), Internal Medicine (29); 4 practice at this address and 21 within 10 miles; [full list](https://npiprofile.com/npi/1770988990/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 21, 2024
- **Other identifiers:** Medicaid 350315301 (TX)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1770988990) · Data from the CMS NPPES public registry.