Austin Fertility Institute, PA

Primary specialty

Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X

License

N5874 Issued in TX

Legal business name

AUSTIN FERTILITY INSTITUTE, PA

Practice address

2200 Park Bend Dr
BLDG. 2 - Suite 204
Austin, TX 78758-5387

Phone

(512) 339-4234

Fax

(512) 339-4237

NPI assigned

Jun 3, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Kamyar Moghadam, MDNPI 1033120282

Title

Director/Physician

Phone

(512) 339-4234

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth K Moghadam, M.D.

  • Reproductive Endocrinology Physician
  • Carmel, IN
  • NPI 1033120282
  NPD (past) Authorized official
• Jenna Marie Wetzel, WHNP

  • Women's Health Nurse Practitioner
  • Austin, TX
  • NPI 1356062319
  NPD (past)

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275523200000",
    "number": "1083934830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 PARK BEND DR",
            "address_2": "BLDG. 2 - SUITE 204",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585387",
            "telephone_number": "512-339-4234",
            "fax_number": "512-339-4237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 PARK BEND DR",
            "address_2": "BLDG. 2 - SUITE 204",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585387",
            "telephone_number": "512-339-4234",
            "fax_number": "512-339-4237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUSTIN FERTILITY INSTITUTE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-03",
        "last_updated": "2010-06-03",
        "status": "A",
        "authorized_official_last_name": "MOGHADAM",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "KAMYAR",
        "authorized_official_title_or_position": "DIRECTOR/PHYSICIAN",
        "authorized_official_telephone_number": "512-339-4234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "TX",
            "license": "N5874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Reproductive Endocrinology Physician in Austin, TX
• Providers in Austin, TX by specialty
• Reproductive Endocrinology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.