Individual provider Active NPI

Mayada Ali, MD

  • Family Medicine Physician
  • Round Rock, TX
National Provider Identifier
1184039489
Registry record updated Jun 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R1490 Issued in TX
Practice address
1000 Gattis School Rd Ste 130
Round Rock, TX 78664-2562
Phone
(512) 649-0996
Fax
(512) 387-3555
NPI assigned
Jun 25, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R1490 TX Primary

Addresses

Primary practice location

1000 Gattis School Rd Ste 130
Round Rock, TX 78664-2562

Mailing address

1000 Gattis School Rd Ste 130
Round Rock, TX 78664-2562
Phone (512) 649-0996

Other identifiers 1

IdentifierTypeStateIssuer
374307208MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL office@bluebonnetprimarycare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Emergency MedicineAlso: Family Practice
Education
Other, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1000 Gattis School Rd
Suite 130
Round Rock, TX 78664-2562

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1490TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeway Era Acquistion Partners LLC Past Accepting new patients
Westlake Complete Care LLC Past Accepting new patients
22250 Bulverde Cec Fossil Creek LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12515/brand/6/csg/1/fhir/r4
  • Direct secure messaging: mayada.ali.1@20143.direct.athenahealth.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": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1184039489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 GATTIS SCHOOL RD STE 130",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786642562",
            "telephone_number": "512-649-0996",
            "fax_number": "512-387-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 GATTIS SCHOOL RD STE 130",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786642562",
            "telephone_number": "512-649-0996",
            "fax_number": "512-387-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "MAYADA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-25",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R1490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "374307208",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "office@bluebonnetprimarycare.com",
            "affiliation": "N",
            "endpointDescription": "business email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1000 Gattis School Rd Ste 130",
            "city": "Round Rock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786642562",
            "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 Jun 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.