Individual provider Active NPI

Constance O'Bryan Cleaves, M. D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Round Rock, TX
National Provider Identifier
1184882474
Registry record updated Jan 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
M9218 Issued in TX
Practice address
302 University Blvd
Round Rock, TX 78665-1032
Phone
(512) 509-0200
NPI assigned
May 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X M9218 TX
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036.117661 IL
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X M9218 TX Primary

Addresses

Primary practice location

302 University Blvd
Round Rock, TX 78665-1032

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-8800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ccleaves11166@direct.sw.org Direct

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
I20090728000329 TX Practitioner - Pathology 0143373811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Texas Tech University Health Science Center School of Medicine, 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)

100 Hillcrest Med Blvde
Waco, TX 76712-8897
Phone (254) 202-5800

100 Medical Pkwy
Lakeway, TX 78738-5621
Phone (512) 571-5000

120 Hillcrest Medical Blvd
Suite 200
Waco, TX 76712-8950
Phone (254) 297-0400

1280 Arrington Rd
Suite 200
College Station, TX 77845-8696
Phone (979) 207-6550

140 Hillcrest Medical Blvd
Waco, TX 76712-8897
Phone (254) 202-8330

150 Hillcrest Medical Blvd
Waco, TX 76712-8897
Phone (254) 202-4000

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

1701 E Pflugerville Pkwy
Baylor Scott and White Clinic Pflug
Pflugerville, TX 78660-8990
Phone (512) 259-6000

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

2600 E Pflugerville Pkwy
Pflugerville, TX 78660-5999

2600 E Pflugerville Pkwy
BLDG 2
Pflugerville, TX 78660-5998
Phone (512) 654-6500

300 University Blvd
Round Rock, TX 78665-1032
Phone (512) 509-0200

302 University Blvd
Round Rock, TX 78665-1032
Phone (512) 509-0200

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

5701 Airport Rd
Temple, TX 76502-7092

700 Scott and White Dr
College Station, TX 77845-6441
Phone (979) 207-0100

800 Scott and White Dr
College Station, TX 77845-6440
Phone (979) 207-4000

800 W Hwy 71
Baylor Scott and White Specialty Clinic
Marble Falls, TX 78654-8602
Phone (830) 201-7100

810 W Hwy 71
Marble Falls, TX 78654-8602
Phone (830) 201-7100

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

900 E Whitestone Blvd
Cedar Park, TX 78613-9093
Phone (512) 684-4911

910 E Whitestone Blvd
Baylor Scott and White Clinic Cedar
Cedar Park, TX 78613-9093
Phone (512) 260-6100

Hospital & facility affiliations

  • Baylor Scott & White Medical Center - Temple Hospital, Temple, TX, CCN 450054
  • Baylor Scott & White Medical Center - Round Rock Hospital, Round Rock, TX, CCN 670034
  • Baylor Scott & White Medical Center- College Stati Hospital, College Station, TX, CCN 670088
  • Baylor Scott & White Medical Center Hillcrest Hospital, Waco, TX, CCN 450101
  • Baylor Scott & White Medical Center Pflugerville Hospital, Pflugerville, TX, CCN 670128

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M9218TXMDCytopathology Physician
036.117661ILMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic CurrentSince Jul 1, 2009 Accepting new patients
Scott & White Clinic CurrentSince Jul 1, 2009 Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

5245 W Highway 290
Austin, TX 78735
Phone (512) 509-0100

101 E Jackson St
Burnet, TX 78611
Phone (512) 756-7510

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

1280 Arrington Rd
Ste 200
College Station, TX 77845
Phone (979) 207-6550

800 Scott and White Dr
College Station, TX 77845
Phone (979) 207-3300

700 Scott and White Dr
College Station, TX 77845
Phone (979) 207-0100

100 Medical Pkwy
Lakeway, TX 78738
Phone (512) 206-8100

810 W Highway 71
Marble Falls, TX 78654
Phone (830) 201-7100

2600 E Pflugerville Pkwy
Ste 100
Pflugerville, TX 78660
Phone (512) 654-6100

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

425 University Blvd
Round Rock, TX 78665
Phone (512) 509-0100

300 University Blvd
Round Rock, TX 78665
Phone (512) 509-0100

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

2401 S 31st St
#200
Temple, TX 76508
Phone (254) 215-0100

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

1901 SW H K Dodgen Loop
Temple, TX 76502
Phone (254) 742-9256

1901 SW H K Dodgen Loop
Bldg 300
Temple, TX 76502
Phone (254) 935-4888

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.

Hospital & facility affiliations 6

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": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1184882474",
    "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",
            "telephone_number": "254-724-8800"
        },
        {
            "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": "CLEAVES",
        "first_name": "CONSTANCE",
        "middle_name": "O'BRYAN",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-23",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "TX",
            "license": "M9218",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036.117661",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "M9218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccleaves11166@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

Verify at the official NPI Registry.