Individual provider Active NPI

Mariya Bobrovnyk, PA-C

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1275089708
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10905 Issued in TX
Practice address
4310 James Casey St Ste 4a
Austin, TX 78745-1120
Phone
(512) 448-4588
Fax
(512) 445-4511
NPI assigned
Aug 25, 2016
Last updated
Aug 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10905 TX Primary

Addresses

Primary practice location

4310 James Casey St Ste 4a
Austin, TX 78745-1120

Mailing address

PO Box 10597
Austin, TX 78766-1597
Phone (512) 485-5889

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161112000135 TX Practitioner - Physician Assistant 7911286000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Austin Gastroenterology PLLCGroup PAC ID 9739174954, 75 clinicians

Practice addresses (Care Compare)

7951 Shoal Creek Blvd
Suite 200
Austin, TX 78757-7581
Phone (512) 454-4588

901 W Ben White Blvd
Austin, TX 78704-6903
Phone (512) 447-2211

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.02 of 100Reported as group
Quality
57.89
Promoting interoperability
96
Improvement activities
40
Cost
78.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA10905TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Gastroenterology PA CurrentSince Jul 1, 2023 Accepting new patients

Locations

4310 James Casey St
Ste 4A
Austin, TX 78745
Phone (512) 532-8000

7951 Shoal Creek Blvd
Ste 200
Austin, TX 78757
Phone (512) 454-4588

7200 Wyoming Springs Dr
Ste 1300
Round Rock, TX 78681

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1472083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1275089708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10597",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787661597",
            "telephone_number": "512-485-5889",
            "fax_number": "512-420-0397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 JAMES CASEY ST STE 4A",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451120",
            "telephone_number": "512-448-4588",
            "fax_number": "512-445-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBROVNYK",
        "first_name": "MARIYA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-25",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.