Individual provider Active NPI

Shelby E Wasil, PA-C

  • Physician Assistant
  • Round Rock, TX
National Provider Identifier
1023502002
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA12855 Issued in TX
Practice address
2000 S Mays St Ste 201
Round Rock, TX 78664-7580
Phone
(512) 244-4272
Fax
(512) 244-2895
NPI assigned
Jun 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA12855 TX Primary

Addresses

Primary practice location

2000 S Mays St Ste 201
Round Rock, TX 78664-7580

Mailing address

101 W Louis Henna Blvd Ste 300
Austin, TX 78728-1203
Phone (512) 492-3743

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190924002350 TX Practitioner - Physician Assistant 5799038626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mark Malone MD PAGroup PAC ID 2567369424, 102 clinicians

Practice addresses (Care Compare)

1106 College St
Suite C
Bastrop, TX 78602-3948
Phone (512) 244-4272

2000 S Mays St
Round Rock, TX 78664-7580
Phone (512) 244-4272

203 N Ih
35 Suite C
Belton, TX 76513-3515
Phone (254) 741-6641

3500 Hillcrest Dr
Suite 1
Waco, TX 76708-3144
Phone (254) 741-6641

6000 S Mopac
Suite 100
Austin, TX 78749
Phone (512) 244-4272

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA12855TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Upmc Community Medicine, Inc CurrentSince Sep 3, 2018 Accepting new patients
Upmc Community Medcine Inc CurrentSince Sep 3, 2018 Accepting new patients
Mark Malone, MD PA CurrentSince Oct 10, 2022 Accepting new patients
Mark Malone MD PA Physician Assistant CurrentSince Oct 10, 2022 Accepting new patients

Locations

875 N Hermitage Rd
Ste 3
Hermitage, PA 16148
Phone (724) 347-4622

339 6th Ave
Fl 5
Pittsburgh, PA 15222
Phone (412) 560-8762

6000 S Mopac Expy
Ste 100
Austin, TX 78749

101 W Louis Henna Blvd
Ste 300
Austin, TX 78728

1106 College St
Ste C
Bastrop, TX 78602
Phone (512) 244-2895

2000 S Mays St
Ste 201
Round Rock, TX 78664
Phone (512) 492-3743

3500 Hillcrest Dr
Ste 1
Waco, TX 76708

Interoperability endpoints

  • Direct secure messaging: shelby.wasil.1@24201.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1023502002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W LOUIS HENNA BLVD STE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787281203",
            "telephone_number": "512-492-3743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S MAYS ST STE 201",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786647580",
            "telephone_number": "512-244-4272",
            "fax_number": "512-244-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASIL",
        "first_name": "SHELBY",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.