Individual provider Active NPI

Brooke Watanabe

  • Emergency Medicine Physician
  • Austin, TX
National Provider Identifier
1083063077
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
R8681 Issued in TX
Practice address
1500 Red River St
Austin, TX 78701
Phone
(512) 324-7000
NPI assigned
Jun 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X R8681 TX Primary

Addresses

Primary practice location

1500 Red River St
Austin, TX 78701

Mailing address

6300 La Calma Dr Ste 200
Austin, TX 78752-3825
Phone (888) 800-8237

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190509001280 TX Practitioner - Emergency Medicine 1052654241 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Travis County Emergency Physicians PA Emergency Medicine CurrentSince Apr 9, 2019 Accepting new patients
Round Table Physicians Group PLLC CurrentSince Nov 18, 2021 Accepting new patients
Austin Critical Care Specialists PA CurrentSince Mar 1, 2020 Accepting new patients
Round Table Specialist Group, PLLC Emergency Medicine Current Accepting new patients
Austin Critical Care Specialists PA CurrentSince Mar 1, 2020 Accepting new patients

Locations

1500 Red River St
Austin, TX 78701
Phone (512) 324-0150

7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305

11113 Research Blvd
Austin, TX 78759
Phone (512) 324-1125

5701 W Slaughter Ln
Bldg G
Austin, TX 78749
Phone (512) 651-5787

1201 W 38th St
Austin, TX 78705
Phone (512) 324-1058

6300 La Calma Dr
Ste 200
Austin, TX 78752
Phone (512) 610-0321

11103 Westheimer Rd
Houston, TX 77042
Phone (832) 708-3651

1014 Wirt Rd
Ste 200
Houston, TX 77055
Phone (713) 527-5000

800 W Central Texas Expy
Killeen, TX 76541
Phone (254) 220-4117

850 W Central Texas Expy
Killeen, TX 76548
Phone (254) 690-0900

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

3011 W Loop 1604 N
San Antonio, TX 78251
Phone (726) 266-7081

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1083063077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 LA CALMA DR STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787523825",
            "telephone_number": "888-800-8237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 RED RIVER ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78701",
            "telephone_number": "512-324-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATANABE",
        "first_name": "BROOKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "R8681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.