Individual provider Active NPI

Michael W Mouw, M.D.

  • Emergency Medicine Physician
  • Austin, TX
National Provider Identifier
1063479376
Registry record updated May 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G5410 Issued in TX
Practice address
601 E 15TH St
Austin, TX 78701-1930
Phone
(512) 324-7000
NPI assigned
Apr 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X G5410 TX
Emergency Medicine Physician 207P00000X G5410 TX Primary

Addresses

Primary practice location

601 E 15TH St
Austin, TX 78701-1930

Mailing address

5616 Ballenton LN
Austin, TX 78739-1742

Other identifiers 1

IdentifierTypeStateIssuer
125535805MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G5410TXMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Victoria Emergency Partners LLC Emergency Medicine CurrentSince Jan 28, 2018 Accepting new patients
Century Integrated Partners, Inc Emergency Medicine CurrentSince Dec 18, 2016 Accepting new patients
Integrative Emergency Services Physician Group PA Emergency Medicine CurrentSince Aug 10, 2016 Accepting new patients
Pearsall Emergency Medicine Associates, PA Emergency Medicine CurrentSince Mar 1, 2018 Accepting new patients
Leading Edge Emergency Physicians, Inc Emergency Medicine Past Accepting new patients
Palestine Principal Healthcare Limited Partnership Emergency Medicine Past Accepting new patients

Locations

3500 Gaston Ave
Dallas, TX 75246

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

1575 S Main St
Ft Worth, TX 76104
Phone (817) 702-8828

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

1110 N Sarah Dewitt Dr
Gonzales, TX 78629
Phone (830) 672-3845

13600 Horizon Blvd
Ste 100
Horizon City, TX 79928
Phone (915) 407-7878

100 Medical Pkwy
Lakeway, TX 78738
Phone (512) 206-8100

200 W Ollie St
Llano, TX 78643
Phone (325) 216-9199

4700 Alliance Blvd
#P
Plano, TX 75093
Phone (469) 814-2000

Interoperability endpoints

  • Direct secure messaging: mmouw169412@ahs.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274227200000",
    "number": "1063479376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5616 BALLENTON LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787391742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E 15TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787011930",
            "telephone_number": "512-324-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUW",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2010-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "G5410",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "G5410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125535805",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.