| Apotheosis Medical Group, Pllc | |
|
423 Treeline Park Ste 310 San Antonio TX 78209-2079 | |
| (409) 201-9654 | |
| (210) 200-8390 |
| Full Name | Apotheosis Medical Group, Pllc |
|---|---|
| Speciality | Hospitalist |
| Location | 423 Treeline Park Ste 310, San Antonio, Texas |
| Authorized Official Name and Position | John L Baeke (PRESIDENT) |
| Authorized Official Contact | 2106654199 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Apotheosis Medical Group, Pllc Po Box 40338 San Antonio TX 78229-1338 Ph: (409) 201-9654 | Apotheosis Medical Group, Pllc 423 Treeline Park Ste 310 San Antonio TX 78209-2079 Ph: (409) 201-9654 |
| NPI Number | 1417763269 |
|---|---|
| Provider Enumeration Date | 12/06/2024 |
| Last Update Date | 09/19/2025 |
| Medicare PECOS PAC ID | 9638607419 |
|---|---|
| Medicare Enrollment ID | O20250107001892 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417763269 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
| 208M00000X | Hospitalist | (* (Not Available)) | Primary |
| Provider Name | Venkatasubramanian Srinivasan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841273729 PECOS PAC ID: 8820078454 Enrollment ID: I20040723000099 |
| Provider Name | Rosslyn W Blake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427201722 PECOS PAC ID: 2668500919 Enrollment ID: I20100507000340 |
| Provider Name | Benyam G Alemu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154646560 PECOS PAC ID: 9537301197 Enrollment ID: I20130809000529 |
| Provider Name | John Baeke |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1831192525 PECOS PAC ID: 6608118039 Enrollment ID: I20210814000167 |
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