SAN TRAN (MD) – Internal Medicine Physician, NPI 1083237788
Internal Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
8,824 INTERNAL MEDICINE in IL
Provider Addresses for SAN TRAN (MD)
PO BOX 844658
DALLAS, TX 752844658
Phone: (800) 994-0371
Fax: (254) 215-9722
Type: Mailing
5905 W CHARLESTON BLVD APT 311
LAS VEGAS, NV 891461376
Phone: (408) 515-0349
Type: Mailing
1500 S FAIRFIELD AVE
CHICAGO, IL 606081782
Phone: (408) 515-0349
Type: Location
1500 S Fairfield Ave
Chicago, IL 606081782
Phone: (408) 515-0349
Type: Location
2401 S 31ST ST
TEMPLE, TX 765080001
Phone: (254) 724-2111
Fax: (254) 724-7603
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $259.
Total Amount is formed as General ($259) + Research ($0) + Ownership ($0) = $259.
Last reported payment date: 2023-04-14 • Largest payer in this snapshot: Boehringer Ingelheim Pharmaceuticals, Inc. ($227).
Total Amount
$259
General + Research + Ownership
Payments
3
Total payment records
General Amount
$259
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-04-14
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-07-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250715002483 | I | Internal Medicine | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 75284)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Radiation Oncology | TX | |
| U R O L O G Y | TX | |
| General Surgery | OK | |
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| - | TX | |
| Anesthesiology Assistant | TX | |
| - | TX | |
| - | TX | |
| O B S T E T R I C S/ G Y N E C O L O G Y | TX | |
| - | TX |
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