Individual provider Active NPI

Elizabeth Marcelle Tammariello

  • Family Nurse Practitioner
  • Austin, TX
National Provider Identifier
1053205591
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1031267 Issued in TX
Practice address
5818 Balcones Dr Ste 200D
Austin, TX 78731-4278
Phone
(512) 400-2042
NPI assigned
Jun 9, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1031267 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

5818 Balcones Dr Ste 200D
Austin, TX 78731-4278

Mailing address

5803 Blanco River Pass
Austin, TX 78749-2837
Phone (337) 371-0374

Other practice location 1

5803 Blanco River Pass
Austin, TX 78749-2837
Phone (337) 371-0374

Other practice location 2

1600 W 38th St Ste 100
Austin, TX 78731-6404
Phone (512) 458-5323

Other names 1

  • Mrs. Marcelle Tammariello Dyas Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1031267TXMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1053205591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5803 BLANCO RIVER PASS",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787492837",
            "telephone_number": "337-371-0374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5818 BALCONES DR STE 200D",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314278",
            "telephone_number": "512-400-2042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5803 Blanco River Pass",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787492837",
            "country_code": "US",
            "telephone_number": "337-371-0374",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 W 38th St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787316404",
            "country_code": "US",
            "telephone_number": "512-458-5323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAMMARIELLO",
        "first_name": "ELIZABETH",
        "middle_name": "MARCELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1031267",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCELLE",
            "last_name": "DYAS",
            "middle_name": "TAMMARIELLO",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.