POLO A. BANUELOS M.D. – NPI #1003072646
Psychiatry & Neurology

A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

Health Care Provider Taxonomy Code for Psychiatry & Neurology

POLO BANUELOS is a psychiatry & neurologist located in SAN ANTONIO, TX. NPPES has assigned the NPI number 1003072646 to POLO BANUELOS on August 04, 2008. It is a Type-1 NPI, indicating this NPI number is associated with an individual. According to the NPI Registry, there are 2 additional location(s) assigned to this provider which are listed below. The primary taxonomy selected by this provider is 2084N0400X from the Health Care Provider Taxonomy code set, which is classified as Psychiatry & Neurology, specializing in Neurology

The NPI profile was previously updated about 3 years ago on Feb 27, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for POLO BANUELOS below.

NPI Profile for
POLO A. BANUELOS

NPI Number
1003072646
Enumeration Date

(about 18 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
POLO A. BANUELOS
Credentials
M.D.
Primary location
11212 STATE HIGHWAY 151
MEDICAL PLAZA 1, SUITE 200
SAN ANTONIO, TX 78251-4498
Phone: (210) 520-7160 Fax: (210) 520-7190
2 Other location(s):
300 Pinellas St # 47
Clearwater, FL 33756-3804
Phone: (727) 462-7907
Fax: (727) 462-7904
1055 Bowles Ave
Suite 200
St. Louis, MO 63117
Phone: (314) 925-4773
Mailing address
9730 WESTOVER HILLS BLVD STE 105
SAN ANTONIO, TX 78251-4842
Phone: (210) 520-7160 Fax: (210) 520-7190
Sole Proprietor
Yes
Updated
Certification Date
Jan 26, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2084N0400X
- Psychiatry & Neurology / Neurology (Primary)		 TX M9832

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

View All Endpoint(s)
Endpoint
[email protected]
Endpoint type
Direct Messaging Address
Endpoint Description
Content Type
OTHER
Affiliation
N
Endpoint Location
1055 BOWLES AVE,
ST. LOUIS, MO 77025-1669
Endpoint
[email protected]
Endpoint type
Direct Messaging Address
Endpoint Description
Content Type
CSV
Affiliation
Y
Endpoint Location
2995 DREW ST FL 2,
CLEARWATER, FL 77025-1669
Endpoint
https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/
Endpoint type
FHIR URL
Endpoint Description
Content Type
OTHER
Affiliation
N
Endpoint Location
1055 BOWLES AVE,
ST. LOUIS, MO 77025-1669

Additional Information

Education
BAYLOR COLLEGE OF MEDICINE - Graduated 2004
Accepts Medicare
This provider accepts Medicare-approved amount as payment in full. The Medicare-approved amount is the total the provider can be paid. When a provider accepts the Medicare-approved amount as payment, you won't be billed for more than the Medicare deductible & coinsureance.
Medicare Ordering & Referring
Provider can:
  • Refer to Part B
  • Order Durable Medical Equipment
  • Refer to Home Health Agency
  • Order Power Mobility Devices
Affiliations
POLO BANUELOS is affiliated with the following medical group(s):
  • HOSPITAL
    • SSM HEALTH ST MARY'S HOSPITAL - ST LOUIS
      6420 CLAYTON RD
      RICHMOND HEIGHTS, MO 63117
    • SSM ST CLARE HEALTH CENTER
      1015 BOWLES
      FENTON, MO 63026

Why is my NPI data (personal information) being displayed publicly?
If you have an active NPI profile, your profile is required to be disclosed according to the FOIA and eFOIA. HIPAA also requires covered providers to share their NPI with other providers, health plans, clearinghouses and any entity that may need it for billing purposes.

How do I correct or change the NPI data displayed here?
At any time, providers can make changes to their NPI profile at NPPES. Login to NPPES to make changes online or call (800) 465-3203 for assistance. Changes made at NPPES will be reflected on this web site within a few days.

Can I hide my NPI profile from the public?
Unfortunately, No. The NPPES discloses health care provider data under the Freedom of Information Act to the public, which means anyone may request such information directly from the National Plan & Provider Enumeration System. See the complete CMS Data Dissemination Notice here.