Individual provider Active NPI

Steven Pavliska, PT

  • Physical Therapist
  • College Station, TX
National Provider Identifier
1194787853
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1151256 Issued in TX
Practice address
1600 University Dr E
College Station, TX 77840-2642
Phone
(409) 691-3300
NPI assigned
Apr 6, 2006
Last updated
Jul 11, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1151256 TX Primary

Addresses

Primary practice location

1600 University Dr E
College Station, TX 77840-2642

Mailing address

PO Box 847556
Dallas, TX 75284-7556
Phone (254) 724-2111

Other identifiers 1

IdentifierTypeStateIssuer
8T4561OtherTXBLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031218000997 TX Practitioner - Physical Therapist in Private Practice 2163329814 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Current Accepting new patients
Scott & White Clinic CurrentSince Sep 1, 2018 Accepting new patients
Scott & White Clinic CurrentSince Sep 1, 2018 Accepting new patients

Locations

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

1600 University Dr E
College Station, TX 77840
Phone (409) 691-3300

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 3

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": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1194787853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847556",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847556",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 UNIVERSITY DR E",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778402642",
            "telephone_number": "409-691-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLISKA",
        "first_name": "STEVEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1151256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "8T4561",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.