Individual provider Active NPI

Matthew Gandy

  • Family Nurse Practitioner
  • Austin, TX
National Provider Identifier
1104525567
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1111397 Issued in TX
Practice address
2200 Park Bend Dr Ste 401
Austin, TX 78758-5387
Phone
(512) 807-3160
NPI assigned
Feb 24, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1111397 TX Primary

Addresses

Primary practice location

2200 Park Bend Dr Ste 401
Austin, TX 78758-5387

Mailing address

2200 Park Bend Dr Ste 401
Austin, TX 78758-5387

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230501000810 TX Practitioner - Nurse Practitioner 8426413204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Davids Heart and Vascular PLLCGroup PAC ID 7012821879, 197 clinicians

Practice addresses (Care Compare)

1900 Scenic Dr
Georgetown, TX 78626-7876

2200 Park Bend
Suite 401
Austin, TX 78758-5509
Phone (512) 807-3160

2200 Park Bend Dr
Austin, TX 78758-5387

3801 N Lamar Blvd
Austin, TX 78756-4080

7215 Wyoming Springs Dr Building 1
Texas Cardiac Arrhythmia
Round Rock, TX 78681-4312
Phone (512) 807-3180

Hospital & facility affiliations

  • St David'S Medical Center Hospital, Austin, TX, CCN 450431
  • Round Rock Medical Center Hospital, Round Rock, TX, CCN 450718
  • North Austin Medical Center Hospital, Austin, TX, CCN 450809

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1111397TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. David'S Cardiology, PLLC CurrentSince Feb 26, 2023 Accepting new patients
St Davids Heart & Vascular, PLLC CurrentSince May 15, 2023 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

3801 N Lamar Blvd
#300
Austin, TX 78756
Phone (512) 206-3600

2200 Park Bend Dr
Ste 401
Austin, TX 78758
Phone (512) 807-3160

1900 Scenic Dr
Ste 3308
Georgetown, TX 78626
Phone (512) 244-2263

Organizations & group practices 2

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 3

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": "1677196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1104525567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 PARK BEND DR STE 401",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 PARK BEND DR STE 401",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585387",
            "telephone_number": "512-807-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDY",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-24",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1111397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.