Individual provider Active NPI

Elizabeth Decker, AA

  • Anesthesiologist Assistant
  • Round Rock, TX
National Provider Identifier
1164572467
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
634 Issued in TX
Practice address
302 University Blvd
Round Rock, TX 78665-1032
Phone
(512) 509-0200
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 004340 GA
Anesthesiologist Assistant 367H00000X 634 TX Primary

Addresses

Primary practice location

302 University Blvd
Round Rock, TX 78665-1032

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address edecker27656@direct.sw.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130925000430 TX Practitioner - Anesthesiology Assistant 3779542378 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

425 University Blvd
Round Rock, TX 78665-1053
Phone (512) 509-0200

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

Hospital & facility affiliations

  • Baylor Scott & White Medical Center - Round Rock Hospital, Round Rock, TX, CCN 670034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
643TXMDOccupational Therapist
004340GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Current Accepting new patients
Scott and White Clinic CurrentSince Dec 26, 2018 Accepting new patients
Scott & White Clinic CurrentSince Dec 26, 2018 Accepting new patients
Anesthesia Associates of Savannah ,PA Past Accepting new patients

Locations

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

1701 E Pflugerville Pkwy
Pflugerville, TX 78660
Phone (512) 259-6000

302 University Blvd
Round Rock, TX 78665
Phone (512) 218-6330

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

546 N Kegley Rd
Temple, TX 76502
Phone (254) 215-0900

Organizations & group practices 4

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 1

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1164572467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 UNIVERSITY BLVD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651032",
            "telephone_number": "512-509-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECKER",
        "first_name": "ELIZABETH",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "004340",
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "TX",
            "license": "634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edecker27656@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "302 University Blvd",
            "city": "Round Rock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786651032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.