NPIMap

Organization Active NPI

Aa OBGYN PLLC

  • Obstetrics & Gynecology Physician
  • Austin, TX
National Provider Identifier
1104170901
Registry record updated Oct 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
AA OBGYN PLLC
Practice address
12200 Renfert Way
Ste 100
Austin, TX 78758-5614
Phone
(512) 451-8211
NPI assigned
Oct 31, 2012
Last updated
Oct 31, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2012

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

Authorized official

Name
Jinous Rouhani
Title
Ceo
Phone
(512) 451-8211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

12200 Renfert Way
Ste 100
Austin, TX 78758-5614

Mailing address

12200 Renfert Way
Ste 100
Austin, TX 78758-5614
Phone (512) 451-8211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130117000089 TX Part B Supplier - Clinic/Group Practice 6103079462 Receives reassigned benefits from 51 practitioners
Practice locations: Austin, TX

National Provider Directory

National Provider Directory

Locations

12200 Renfert Way
Austin, TX 78758
Phone (512) 451-8211

12200 Renfert Way
Ste 10
Austin, TX 78758

Practitioners & affiliated clinicians

Practitioners 55

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 55

NPI Registry JSON

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351641600000",
    "number": "1104170901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 RENFERT WAY",
            "address_2": "STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585614",
            "telephone_number": "512-451-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 RENFERT WAY",
            "address_2": "STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585614",
            "telephone_number": "512-451-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AA OBGYN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-31",
        "last_updated": "2012-10-31",
        "status": "A",
        "authorized_official_last_name": "ROUHANI",
        "authorized_official_first_name": "JINOUS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-451-8211"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Oct 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.