Individual provider Active NPI

Shivanand Bomman, MD

  • Gastroenterology Physician
  • Round Rock, TX
National Provider Identifier
1063641348
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
W3658 Issued in TX
Practice address
7200 Wyoming Springs Dr Ste 1300
Round Rock, TX 78681-4306
Phone
(512) 244-2273
Fax
(512) 244-3179
NPI assigned
Jul 8, 2009
Last updated
Sep 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X W3658 TX Primary

Addresses

Primary practice location

7200 Wyoming Springs Dr Ste 1300
Round Rock, TX 78681-4306

Mailing address

PO Box 10597
Austin, TX 78766-1597
Phone (512) 420-0186

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250826001644 AZ Practitioner - Gastroenterology 0446402846 Reassigns benefits to 1 organization
I20260506002816 TX Practitioner - Gastroenterology 0446402846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner-University Medical GroupGroup PAC ID 7719899871, 1,066 clinicians

Practice addresses (Care Compare)

3838 N Campbell Ave
BLDG 2
Tucson, AZ 85719-1454
Phone (520) 694-8888

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy13
Upper gastrointestinal (GI) endoscopy for acid reflux20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14557NVMDInternal Medicine Physician
R79307AZMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Internal Medicine Current Accepting new patients
Banner-University Medical Group Internal Medicine CurrentSince Sep 1, 2025 Accepting new patients
Banner-University Medical Group CurrentSince Sep 1, 2025 Accepting new patients
Inpatient Consultants of Nevada, Inc. a Medical Corporation Internal Medicine Past Accepting new patients

Locations

1625 N Campbell Ave
Tucson, AZ 85719

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

2800 E Ajo Way
Bldg 100
Tucson, AZ 85713
Phone (520) 419-5820

3838 N Campbell Ave
Bldg 2
Tucson, AZ 85719

202 N Division St
Auburn, WA 98001
Phone (253) 333-2562

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1063641348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10597",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787661597",
            "telephone_number": "512-420-0186",
            "fax_number": "903-200-5107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 WYOMING SPRINGS DR STE 1300",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814306",
            "telephone_number": "512-244-2273",
            "fax_number": "512-244-3179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMMAN",
        "first_name": "SHIVANAND",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-08",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "W3658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.