Individual provider Active NPI

Vivian Conroy

  • Physician Assistant
  • West Lake Hills, TX
National Provider Identifier
1033827647
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18528 Issued in TX
Practice address
3300 Bee Caves Rd Ste 440
West Lake Hills, TX 78746-6770
Phone
(512) 399-0402
Fax
(844) 460-2062
NPI assigned
Nov 11, 2022
Last updated
Mar 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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 PA18528 TX Primary
Emergency Medicine Physician 207P00000X PA62237 CA

Addresses

Primary practice location

3300 Bee Caves Rd Ste 440
West Lake Hills, TX 78746-6770

Mailing address

2920 Telegraph Ave Ste 100
Berkeley, CA 94705-2031
Phone (415) 329-3727

Other practice location 1

235 E 17th St
Costa Mesa, CA 92627-3831
Phone (949) 688-2010

Other practice location 2

631 S Brookhurst St
Anaheim, CA 92804-3510
Phone (714) 991-5700

Other names 1

  • Vivian Jasmine Cheng Other name

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
I20241216002131 TX Practitioner - Physician Assistant 9234590290 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors Express of the Beaumont Area PAGroup PAC ID 5698816882, 211 clinicians

Practice addresses (Care Compare)

17903 W Lake Houston Pkwy
Suite 101
Atascocita, TX 77346-3954
Phone (215) 570-6856

6600 S Mopac Expy
Suite 2180
Austin, TX 78749-1430
Phone (512) 522-3010

9722 Great Hills TRL
Suite 375
Austin, TX 78759-7263
Phone (512) 910-3932

Merit-based Incentive Payment System (MIPS)

Final score
95.31 of 100Reported as group
Quality
83.88
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA62237CAMDEmergency Medicine Physician
PA18528TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Medical Group of Florida PA CurrentSince Dec 11, 2024 Accepting new patients
Carbon Health Medical Group of Florida PA CurrentSince Dec 11, 2024 Accepting new patients
Southlake Doctors Express, PA PSC Current Accepting new patients

Locations

2920 Telegraph Ave
Ste 100
Berkeley, CA 94705
Phone (415) 329-3727

17903 W Lake Houston Pkwy
Ste 101
Humble, TX 77346
Phone (215) 570-6856

19220 S Ih 35
Ste 300
Kyle, TX 78640
Phone (737) 265-3964

2315 E Southlake Blvd
Ste 110
Southlake, TX 76092
Phone (817) 488-9922

3300 Bee Caves Rd
Ste 440
West Lake Hills, TX 78746
Phone (512) 399-0402

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1668124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1033827647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 TELEGRAPH AVE STE 100",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052031",
            "telephone_number": "415-329-3727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 BEE CAVES RD STE 440",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787466770",
            "telephone_number": "512-399-0402",
            "fax_number": "844-460-2062"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "235 E 17th St",
            "address_purpose": "LOCATION",
            "city": "Costa Mesa",
            "state": "CA",
            "postal_code": "926273831",
            "country_code": "US",
            "telephone_number": "949-688-2010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "631 S Brookhurst St",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928043510",
            "country_code": "US",
            "telephone_number": "714-991-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONROY",
        "first_name": "VIVIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-11",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18528",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "PA62237",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VIVIAN",
            "last_name": "CHENG",
            "middle_name": "JASMINE",
            "credential": "PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in West Lake Hills, TX

Sources for this page

Verify at the official NPI Registry.