Individual provider Active NPI

Dane Stephen Pawlowski, MD

  • Family Medicine Physician
  • Rio Grande City, TX
National Provider Identifier
1104278464
Registry record updated Jul 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
S1483 Issued in TX
Practice address
128 N FM 3167
Rio Grande City, TX 78582
Phone
(956) 487-9025
Fax
(956) 487-4680
NPI assigned
Jul 11, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X S1483 TX
Family Medicine Physician 207Q00000X S1483 TX Primary

Addresses

Primary practice location

128 N FM 3167
Rio Grande City, TX 78582

Mailing address

PO Box 749
Pharr, TX 78577-1614
Phone (956) 487-9025

Other practice location 1

11130 Christus Hls
3rd Floor
San Antonio, TX 78251-3585
Phone (210) 703-9001

Other practice location 2

11130 Christus Hls
3rd Floor
San Antonio, TX 78251-3585
Phone (210) 703-9001

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
I20190613002862 TX Practitioner - Family PracticePractitioner - Emergency Medicine 4486947975 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Texas a & M University System, HSC, College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group Gulf Coast PLLCGroup PAC ID 4688999022, 511 clinicians

Practice addresses (Care Compare)

17510 W Grand Pkwy S
Sugar Land, TX 77479-2649

3201 University Dr E
200 Brazos Valley Family and Preventative
Bryan, TX 77802-3431
Phone (979) 272-4156

7900 Fannin St
Suite 4000
Houston, TX 77054-2935
Phone (713) 512-7500

Hospital & facility affiliations

  • Allumine Home Health Home health agency, College Station, TX, CCN 747725
  • CHI St Joseph Health Regional Hospital Hospital, Bryan, TX, CCN 450011
  • Physicians Centre,the Hospital, Bryan, TX, CCN 450834
  • Baylor Scott & White Medical Center- College Stati Hospital, College Station, TX, CCN 670088

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S1483TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Gulf Coast PLLC CurrentSince May 18, 2024 Accepting new patients
Privia Medical Group Gulf Coast, PLLC CurrentSince May 18, 2024 Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Aug 22, 2019 Accepting new patients
Concord Medical Group PLLC Emergency Medicine CurrentSince Mar 2, 2023 Accepting new patients

Locations

44 N Cummings St
Bellville, TX 77418
Phone (979) 413-7400

200 S Geneva St
Breckenridge, TX 76424
Phone (254) 559-2241

3201 University Dr E
Ste 200
Bryan, TX 77802
Phone (979) 268-7914

646 FM 517 Rd W
Dickinson, TX 77539
Phone (281) 309-9001

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

7900 Fannin St
Ste 4000
Houston, TX 77054
Phone (713) 512-7027

110 Memorial Hospital Dr
Huntsville, TX 77340
Phone (936) 291-4276

10970 Shadow Creek Pkwy
Ste 100
Pearland, TX 77584
Phone (281) 398-8500

17510 W Grand Pkwy S
Ste 430
Sugar Land, TX 77479
Phone (713) 578-3820

Interoperability endpoints

  • Direct secure messaging: dane.pawlowski.1@8042.direct.athenahealth.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.

Hospital & facility affiliations 5

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": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1104278464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785771614",
            "telephone_number": "956-487-9025",
            "fax_number": "956-487-4680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 N FM 3167",
            "city": "RIO GRANDE CITY",
            "state": "TX",
            "postal_code": "78582",
            "telephone_number": "956-487-9025",
            "fax_number": "956-487-4680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11130 Christus Hls",
            "address_2": "3rd Floor",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782513585",
            "country_code": "US",
            "telephone_number": "210-703-9001",
            "fax_number": "210-703-9155",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11130 Christus Hls",
            "address_2": "3rd Floor",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782513585",
            "country_code": "US",
            "telephone_number": "210-703-9001",
            "fax_number": "210-703-9155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAWLOWSKI",
        "first_name": "DANE",
        "middle_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-11",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "S1483",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S1483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Grande City, TX

Sources for this page

Verify at the official NPI Registry.