Centromed South Park Medical Clinic - Medicare Primary Care in San Antonio, TX

Centromed South Park Medical Clinic is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in San Antonio, Texas. The current practice location for Centromed South Park Medical Clinic is 6315 S Zarzamora St, San Antonio, Texas. For appointments, you can reach them via phone at (210) 977-7910. The mailing address for Centromed South Park Medical Clinic is 3750 Commercial Ave, San Antonio, Texas and phone number is (210) 334-3700.

Centromed South Park Medical Clinic is licensed to practice in Texas (license number H76HA00124). The clinic also participates in the medicare program and its NPI number is 1538264429. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (210) 977-7910.

Contact Information

Centromed South Park Medical Clinic
6315 S Zarzamora St
San Antonio
TX 78211-3218
(210) 977-7910
(210) 924-2165

Map and Direction


Primary Care Clinic Profile

Full NameCentromed South Park Medical Clinic
SpecialityClinic/Center
Location6315 S Zarzamora St, San Antonio, Texas
Authorized Official Name and PositionChuck Walzel (CHIEF FINANCIAL OFFICER)
Authorized Official Contact2103343724
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Centromed South Park Medical Clinic
3750 Commercial Ave
San Antonio
TX 78221-3117

Ph: (210) 334-3700
Centromed South Park Medical Clinic
6315 S Zarzamora St
San Antonio
TX 78211-3218

Ph: (210) 977-7910

NPI Details:

NPI Number1538264429
Provider Enumeration Date09/14/2006
Last Update Date10/11/2019

Medicare PECOS Information:

Medicare PECOS PAC ID6800881285
Medicare Enrollment IDO20040415001061

Medical Identifiers

Medical identifiers for Centromed South Park Medical Clinic such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1538264429NPI-NPPES
00MT08OtherTXGROUP MEDICARE
120980103MedicaidTX
120980105MedicaidTX
120980101MedicaidTX
120980102MedicaidTX

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
261QF0400XClinic/center - Federally Qualified Health Center (fqhc) H76HA00124 (Texas)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Centromed South Park Medical Clinic acts as a billing entity for following providers:
Provider NameGerardo P Enriquez
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1295746774
PECOS PAC ID: 6507845047
Enrollment ID: I20040717000090
Provider NameRosa L Combs
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1508967803
PECOS PAC ID: 7214996438
Enrollment ID: I20041005000161
Provider NameSylvia Allen
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1275647679
PECOS PAC ID: 5890743355
Enrollment ID: I20050111000710
Provider NameAysun Alagoz
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1750492690
PECOS PAC ID: 5395798839
Enrollment ID: I20050224000819
Provider NameMelissa Rodriguez
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1285691667
PECOS PAC ID: 2264456466
Enrollment ID: I20060113000732
Provider NameMagdalena Verduzco
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164445375
PECOS PAC ID: 9638271372
Enrollment ID: I20070226000778
Provider NameErnesto O Parra
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1013937234
PECOS PAC ID: 2860593878
Enrollment ID: I20070720000482
Provider NameAdriana Uribe
Provider TypePractitioner - Podiatry
Provider IdentifiersNPI Number: 1154308955
PECOS PAC ID: 7416928882
Enrollment ID: I20070915000188
Provider NameLisa R Huizar
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1851434468
PECOS PAC ID: 7012072796
Enrollment ID: I20090212000272
Provider NameJuan Parra
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1649289984
PECOS PAC ID: 9234282765
Enrollment ID: I20090731000327
Provider NameCelia B Alviso
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1174858591
PECOS PAC ID: 1850430398
Enrollment ID: I20091123000463
Provider NameCielo C Manriquez
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1376595793
PECOS PAC ID: 7012946478
Enrollment ID: I20100224000161
Provider NameNonyerem N Osuji
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1366536039
PECOS PAC ID: 0042345894
Enrollment ID: I20100318000075
Provider NameCynthia Z Mazuca
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1063733608
PECOS PAC ID: 9537284534
Enrollment ID: I20100914001201
Provider NameNorma G Parra
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1912927997
PECOS PAC ID: 9234322231
Enrollment ID: I20101022000559
Provider NameRafael H Martinez
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1942217278
PECOS PAC ID: 1951594977
Enrollment ID: I20101022000824
Provider NameSergio Ricardo Rodriguez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1881908077
PECOS PAC ID: 6608060819
Enrollment ID: I20101102000480
Provider NameHerbert Guzman-cruz
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1063526283
PECOS PAC ID: 8426242579
Enrollment ID: I20101102001068
Provider NameSoheir H Girgis
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1306950746
PECOS PAC ID: 1456545276
Enrollment ID: I20101104001460
Provider NameDenise P Uchoa
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1427053982
PECOS PAC ID: 8426001843
Enrollment ID: I20110721000539
Provider NameScheel L Nayar
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1104841873
PECOS PAC ID: 6800797465
Enrollment ID: I20110920000077
Provider NameVeronica S Betancur
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1306008388
PECOS PAC ID: 4981875697
Enrollment ID: I20110928000604
Provider NameCristine G Hernandez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306193628
PECOS PAC ID: 6103075726
Enrollment ID: I20120925000580
Provider NameMichael D Stevens
Provider TypePractitioner - Optometry
Provider IdentifiersNPI Number: 1558347419
PECOS PAC ID: 9830349729
Enrollment ID: I20121031000291
Provider NameFelix C W Koo
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1033327663
PECOS PAC ID: 0547179095
Enrollment ID: I20130208000117
Provider NameKrystle N De La Rosa
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1366738015
PECOS PAC ID: 3678727872
Enrollment ID: I20130215000123
Provider NameKevin John Dasher
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1386602712
PECOS PAC ID: 1951455187
Enrollment ID: I20130228000502
Provider NameMelissa M Garcia
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1851732382
PECOS PAC ID: 7214170638
Enrollment ID: I20130903000659
Provider NameHilda M Rivera Santiago
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1972568160
PECOS PAC ID: 2668608365
Enrollment ID: I20131203000814
Provider NameJuliana L Robles
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1811288467
PECOS PAC ID: 9436374832
Enrollment ID: I20140626002106
Provider NameJessica L Molina
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1205120359
PECOS PAC ID: 4385864719
Enrollment ID: I20141006002149
Provider NameDelia Gonzales Silvas
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1508269077
PECOS PAC ID: 6709008899
Enrollment ID: I20141104002727
Provider NameMayra Pena
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1922345495
PECOS PAC ID: 7810200490
Enrollment ID: I20150727000399
Provider NameAngelica M Pentecost
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1699173435
PECOS PAC ID: 6507172483
Enrollment ID: I20150909000728
Provider NameJoanne B Bassali
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1215014071
PECOS PAC ID: 9234316720
Enrollment ID: I20150909001231
Provider NameSpencer R Lewis
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1245596063
PECOS PAC ID: 6002125093
Enrollment ID: I20151013002223
Provider NameRobert Phillip Meyer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1144670944
PECOS PAC ID: 7911292370
Enrollment ID: I20160824000728
Provider NameHanaa Farid Haleen Girgis
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1124461801
PECOS PAC ID: 9739302092
Enrollment ID: I20160906002118
Provider NamePrabhjot Randev
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1275969982
PECOS PAC ID: 2860771888
Enrollment ID: I20161115002609
Provider NameIsamarie Lora Alcantara
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1871830281
PECOS PAC ID: 5395027445
Enrollment ID: I20170125000446
Provider NameJennifer Velasquez
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1538605779
PECOS PAC ID: 0547545477
Enrollment ID: I20170316000292
Provider NameAndrea R Kephart
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1245762657
PECOS PAC ID: 0143507079
Enrollment ID: I20170502002754
Provider NameMelody Munoz
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1982022240
PECOS PAC ID: 4486921368
Enrollment ID: I20170524002274
Provider NameJennifer A Bugna
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1831577733
PECOS PAC ID: 2264780907
Enrollment ID: I20180813000863
Provider NameHolly C Lacy
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1477023554
PECOS PAC ID: 1850633454
Enrollment ID: I20190501001129
Provider NameDaniel V Vijjeswarapu
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1407926629
PECOS PAC ID: 3577896034
Enrollment ID: I20190614002278
Provider NameTiffany W Bruce
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1811555832
PECOS PAC ID: 6507190543
Enrollment ID: I20190626000448
Provider NamePedro Zavala
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1275995771
PECOS PAC ID: 6204164320
Enrollment ID: I20190827001823
Provider NameJuan E Carballo
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1497983134
PECOS PAC ID: 3476882713
Enrollment ID: I20190911001719
Provider NameRosalio Jalomo
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1801857644
PECOS PAC ID: 7315276672
Enrollment ID: I20190911002569
Provider NameLuis A Rodriguez
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1801857560
PECOS PAC ID: 4486983749
Enrollment ID: I20190911002671
Provider NameAshley J Lopez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1437668787
PECOS PAC ID: 6709115074
Enrollment ID: I20190911002890
Provider NameLeah Mercado
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1932410735
PECOS PAC ID: 2365771508
Enrollment ID: I20190912002083
Provider NameClevert Tseng
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1134180995
PECOS PAC ID: 7719216951
Enrollment ID: I20190912002104
Provider NameGabriel M Perez
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1053598771
PECOS PAC ID: 7618206863
Enrollment ID: I20190912002543
Provider NameBrittany N Lewis
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1336428432
PECOS PAC ID: 5799014973
Enrollment ID: I20190913000445
Provider NameMichelle D Lewis
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1871662635
PECOS PAC ID: 5092045088
Enrollment ID: I20190917003582
Provider NameAna L Cabrera
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1699316166
PECOS PAC ID: 6800051178
Enrollment ID: I20191220001696
Provider NameYuly D Carreras
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1861735128
PECOS PAC ID: 9931533163
Enrollment ID: I20191223000207
Provider NameSamantha D Gonzalez Ramos
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1699157495
PECOS PAC ID: 8325473515
Enrollment ID: I20200116000767
Provider NameAna Maria Escobar-botero
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1992115752
PECOS PAC ID: 0345597902
Enrollment ID: I20200806003252
Provider NameDaniel A Escobar Jimenez
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1588074561
PECOS PAC ID: 7517263957
Enrollment ID: I20200807000196
Provider NameKatherine L Villarreal
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1770198616
PECOS PAC ID: 8820417165
Enrollment ID: I20201006000868
Provider NameDanielle L Hanson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1750961819
PECOS PAC ID: 0648679217
Enrollment ID: I20210602000566
Provider NameAyisat A Enifeni
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1699209932
PECOS PAC ID: 9133521008
Enrollment ID: I20210714003418
Provider NameSarah E Lutka
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1558034371
PECOS PAC ID: 4284038167
Enrollment ID: I20210816000268
Provider NameJazmin M Jackson
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1245529254
PECOS PAC ID: 6608090865
Enrollment ID: I20210924000262
Provider NameMartha Guadalupe Garza
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1124798558
PECOS PAC ID: 1254720477
Enrollment ID: I20211109003479
Provider NameStephania Galindo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1326620865
PECOS PAC ID: 0749672350
Enrollment ID: I20220111001547
Provider NameHerman Castillo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1699427534
PECOS PAC ID: 0648687368
Enrollment ID: I20220301000073
Provider NamePhelicia N Ford-ross
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1376130252
PECOS PAC ID: 8123406196
Enrollment ID: I20220602002423
Provider NameGina Padron
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1225646698
PECOS PAC ID: 3072991983
Enrollment ID: I20220606002116
Provider NameDaniel Trevino
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1346242393
PECOS PAC ID: 1658759576
Enrollment ID: I20220606002407
Provider NameSheila M Msengi
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1871263517
PECOS PAC ID: 4789062522
Enrollment ID: I20220607000469
Provider NameHelen K Morrison
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548734916
PECOS PAC ID: 3779961511
Enrollment ID: I20220607000489
Provider NameJennifer Y Dimas
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548725658
PECOS PAC ID: 3476931221
Enrollment ID: I20220607001035
Provider NameJennifer B Hessock
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1700118916
PECOS PAC ID: 6204017874
Enrollment ID: I20220608000330
Provider NameSung Un Lee
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1154891034
PECOS PAC ID: 2961880638
Enrollment ID: I20220608002308
Provider NameAshley Sareen
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1053872317
PECOS PAC ID: 3072992411
Enrollment ID: I20220615002218
Provider NameSherida Suarez Dinzey
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1780146712
PECOS PAC ID: 4284015470
Enrollment ID: I20220719003157
Provider NameMyriam Alexa Hinojosa
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1851852917
PECOS PAC ID: 2668853474
Enrollment ID: I20220725002074
Provider NameOluyemisi O Akintunde
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1366468241
PECOS PAC ID: 4284692138
Enrollment ID: I20220727000193
Provider NameKristen Ashley Nerdahl
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1386314995
PECOS PAC ID: 6305220286
Enrollment ID: I20220825003201
Provider NameStephanie Anne Aviles
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1003488255
PECOS PAC ID: 2365818960
Enrollment ID: I20221024001392
Provider NameStephanie N Stewart
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1629578620
PECOS PAC ID: 1951766922
Enrollment ID: I20230426000879
Provider NameShruti U Patel
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1639521495
PECOS PAC ID: 0143557637
Enrollment ID: I20230515001000
Provider NameMary L Hernandez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1225735889
PECOS PAC ID: 8123484920
Enrollment ID: I20230522001044
Provider NameAna M Montanez Concepcion
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1679875934
PECOS PAC ID: 9638322431
Enrollment ID: I20230724001105
Provider NameApril Christine Gallegos
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780454355
PECOS PAC ID: 6406299502
Enrollment ID: I20240206001493
Provider NameGencie Lamont Leonard
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1154183838
PECOS PAC ID: 9335588813
Enrollment ID: I20240416004486

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.