Individual provider Active NPI

Andrea Zeddies, PH,D

  • Clinical Psychologist
  • Austin, TX
National Provider Identifier
1285799544
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
32029 Issued in TX
Practice address
406 W 30TH St
Austin, TX 78705-2804
Phone
(512) 495-9556
Fax
(512) 495-9774
NPI assigned
Dec 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 32029 TX Primary

Addresses

Primary practice location

406 W 30TH St
Austin, TX 78705-2804

Mailing address

406 W 30TH St
Austin, TX 78705-2804
Phone (512) 495-9556

Other identifiers 1

IdentifierTypeStateIssuer
0054JNOtherTXBCBS

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040615000551 TX Practitioner - Clinical Psychologist 2062496326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2001
Medicare assignment
May accept Medicare assignment
Group practices
Central Austin Psychology Group, PLLCGroup PAC ID 1951639053, 2 clinicians

Practice addresses (Care Compare)

3307 Northland Dr
Suite 290
Austin, TX 78731-4984
Phone (512) 495-9556

5926 Balcones Dr
Suite 212
Austin, TX 78731-4299

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32029TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Austin Psychology Group, PLLC Clinical CurrentSince Apr 1, 2020 Accepting new patients

Locations

5926 Balcones Dr
Ste 212
Austin, TX 78731
Phone (512) 294-9798

3307 Northland Dr
Ste 290
Austin, TX 78731
Phone (512) 495-9556

Organizations & group practices 1

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": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285799544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 W 30TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787052804",
            "telephone_number": "512-495-9556",
            "fax_number": "512-495-9774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 W 30TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787052804",
            "telephone_number": "512-495-9556",
            "fax_number": "512-495-9774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEDDIES",
        "first_name": "ANDREA",
        "credential": "PH,D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "32029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0054JN",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.