Individual provider Active NPI

Jerett Aaron Zipin, D.O.

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Pflugerville, TX
National Provider Identifier
1154386829
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X
License
S1025 Issued in TX
Practice address
2100 Autumn Slate Dr Ste 150
Pflugerville, TX 78660
Phone
(737) 220-7200
Fax
(512) 406-7339
NPI assigned
Apr 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X S1025 TX Primary

Addresses

Primary practice location

2100 Autumn Slate Dr Ste 150
Pflugerville, TX 78660

Mailing address

6210 E Highway 290
Austin, TX 78723-1142
Phone (512) 483-9569

Other identifiers 2

IdentifierTypeStateIssuer
400567002MedicaidTX
400567001MedicaidTX

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
I20190627001396 TX Practitioner - Sports Medicine 7315917754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 1999
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)

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 Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Regional Clinic, PA CurrentSince Jun 10, 2019 Accepting new patients
Austin Regional Clinic, PA CurrentSince Jun 10, 2019 Accepting new patients

Locations

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

6210 E Highway 290
Ste 420
Austin, TX 78723
Phone (512) 338-3802

6210 E Highway 290
Austin, TX 78723

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

2100 Autumn Slate Dr
Ste 150
Pflugerville, TX 78660
Phone (737) 220-7200

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

Interoperability endpoints

  • Direct secure messaging: jzipin21157@arcmd.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1154386829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 E HIGHWAY 290",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787231142",
            "telephone_number": "512-483-9569",
            "fax_number": "512-406-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 AUTUMN SLATE DR STE 150",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "78660",
            "telephone_number": "737-220-7200",
            "fax_number": "512-406-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIPIN",
        "first_name": "JERETT",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "TX",
            "license": "S1025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400567002",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400567001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pflugerville, TX

Sources for this page

Verify at the official NPI Registry.