Active NPI
Kevin Lee Hoffarth, MD
- Family Medicine Physician
- Lakeway, TX
National Provider Identifier
1275530826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- P3000
- Practice address
- 200 Medical Pkwy
Suite 310
Lakeway, TX 78738-1782 - Phone
- (512) 654-2100
- Fax
- (512) 654-2110
- NPI assigned
- Jun 28, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A81044 | CA | |
| Family Medicine Physician | 207Q00000X | P3000 | TX | Primary |
Addresses
Primary practice location
200 Medical Pkwy
Suite 310
Lakeway, TX 78738-1782
Mailing address
200 Medical Pkwy
Suite 310
Lakeway, TX 78738-1782
Phone (512) 654-2100
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A810440 | Medicaid | CA | |
| 100508905 | Medicaid | NV | |
| 100508675 | Medicaid | NV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 8, 2022 through Dec 8, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A81044 | CA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350864000000",
"number": "1275530826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 MEDICAL PKWY",
"address_2": "SUITE 310",
"city": "LAKEWAY",
"state": "TX",
"postal_code": "787381782",
"telephone_number": "512-654-2100",
"fax_number": "512-654-2110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 MEDICAL PKWY",
"address_2": "SUITE 310",
"city": "LAKEWAY",
"state": "TX",
"postal_code": "787381782",
"telephone_number": "512-654-2100",
"fax_number": "512-654-2110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOFFARTH",
"first_name": "KEVIN",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-28",
"last_updated": "2012-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A81044",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "P3000",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A810440",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100508905",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100508675",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakeway, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.