Individual provider Active NPI

Boris A Gritzka, MD

  • Pediatrics Physician
  • Austin, TX
National Provider Identifier
1124033287
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
L2288 Issued in TX
Practice address
3816 S 1St St
Austin, TX 78704-7048
Phone
(512) 443-1311
Fax
(512) 406-6266
NPI assigned
Jul 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X L2288 TX Primary

Addresses

Primary practice location

3816 S 1St St
Austin, TX 78704-7048

Mailing address

6210 E Hwy 290
Austin, TX 78723-1142

Other identifiers 2

IdentifierTypeStateIssuer
146600504MedicaidTX
146600503MedicaidTX

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
I20110315000189 TX Practitioner - Pediatric Medicine 4587846498 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Austin Regional Clinic PAGroup PAC ID 3072507789, 398 clinicians

Practice addresses (Care Compare)

151 Exchange Blvd
500 Arc Hutto
Hutto, TX 78634-5381
Phone (512) 846-1244

3816 S 1St St
Austin, TX 78704-7048
Phone (512) 443-1311

3828 S 1St St
Arc South 1St
Austin, TX 78704-7048
Phone (512) 443-1311

6835 Austin Ctr Blvd
Austin, TX 78731-3166
Phone (512) 346-6611

940 Hesters Crossing Rd
Round Rock, TX 78681-8018
Phone (512) 244-9024

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Regional Clinic, PA CurrentSince Nov 24, 2010 Accepting new patients
Austin Regional Clinic, PA Pediatrics CurrentSince Nov 24, 2010 Accepting new patients
Seton Hospitalist Service Past Accepting new patients

Locations

4515 Seton Center Pkwy
Ste 215
Austin, TX 78759
Phone (512) 338-3802

6835 Austin Center Blvd
Austin, TX 78731
Phone (512) 231-5210

6210 E Highway 290
Austin, TX 78723

3816 S 1st St
Austin, TX 78704
Phone (512) 443-1311

151 Exchange Blvd
Ste 500
Hutto, TX 78634
Phone (512) 846-1244

Interoperability endpoints

  • Direct secure messaging: bgritzka12754@arcmd.direct-ci.com

Organizations & group practices 3

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": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1124033287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 E HWY 290",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787231142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3816 S 1ST ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787047048",
            "telephone_number": "512-443-1311",
            "fax_number": "512-406-6266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRITZKA",
        "first_name": "BORIS",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "L2288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146600504",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146600503",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.