Individual provider Active NPI

Paul Abram Shrogin, D.C.

  • Chiropractor
  • Austin, TX
National Provider Identifier
1275907263
Registry record updated Jul 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
13075 Issued in TX
Practice address
9701 Brodie LN Ste 202
Austin, TX 78748
Phone
(805) 478-3760
NPI assigned
Nov 14, 2015
Reactivated
Nov 14, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 13075 TX Primary

Addresses

Primary practice location

9701 Brodie LN Ste 202
Austin, TX 78748

Mailing address

9701 Brodie LN Ste 202
Austin, TX 78748-6284
Phone (805) 478-3760

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180730001031 TX Practitioner - Chiropractic 1456609049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9701 Brodie LN
Suite 202
Austin, TX 78748-6284
Phone (512) 326-2520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13075TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson PK, LLC CurrentSince Jul 11, 2018 Accepting new patients
Brain Synergy Institute, LLC Current Accepting new patients

Locations

9701 Brodie Ln
Ste 202
Austin, TX 78748
Phone (512) 326-2520

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": "1447459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1275907263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9701 BRODIE LN STE 202",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787486284",
            "telephone_number": "805-478-3760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 BRODIE LN STE 202",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78748",
            "telephone_number": "805-478-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHROGIN",
        "first_name": "PAUL",
        "middle_name": "ABRAM",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-14",
        "last_updated": "2018-07-12",
        "deactivation_date": "2017-11-09",
        "reactivation_date": "2017-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "13075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.