Individual provider Active NPI

Michelle Ann George, MD

  • Pediatrics Physician
  • Austin, TX
National Provider Identifier
1255788097
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
S0454 Issued in TX
Practice address
1210 W Braker LN
Austin, TX 78758-3801
Phone
(512) 978-9300
Fax
(512) 901-9737
NPI assigned
May 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X BP10055835 TX
Pediatrics Physician 208000000X S0454 TX Primary

Addresses

Primary practice location

1210 W Braker LN
Austin, TX 78758-3801

Mailing address

1210 W Braker LN
Austin, TX 78758-3801
Phone (512) 978-9300

Other names 1

  • Michelle Mathew Former name

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
I20251217004344 TX Practitioner - Pediatric Medicine 5698002897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Texas Tech University Health Science Center School of Medicine, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1210 W Braker LN
Austin, TX 78758-3801

2115 Kramer LN
Suite 100
Austin, TX 78758-4013

PO Box
Suite 5478
Pawtucket, RI 02862

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10055835TXMDPediatrics Physician
S0454TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Texas Community Health Centers CurrentSince Oct 3, 2025 Accepting new patients
Central Texas Community Health Centers CurrentSince Oct 3, 2025 Accepting new patients

Locations

1210 W Braker Ln
Austin, TX 78758
Phone (512) 978-9300

301 W State Highway 71
Ste 111
Bastrop, TX 78602
Phone (512) 304-0318

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1255788097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 W BRAKER LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787583801",
            "telephone_number": "512-978-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W BRAKER LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787583801",
            "telephone_number": "512-978-9300",
            "fax_number": "512-901-9737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "MICHELLE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-23",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "BP10055835",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "S0454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "MATHEW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.