Individual provider Active NPI

Timothy F Kolda, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Austin, TX
National Provider Identifier
1295790608
Registry record updated Mar 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
J2137 Issued in TX
Practice address
3445 Executive Center Dr
Suite 250
Austin, TX 78731-1678
Phone
(512) 579-4000
Fax
(512) 439-2814
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X J2137 TX Primary

Addresses

Primary practice location

3445 Executive Center Dr
Suite 250
Austin, TX 78731-1678

Mailing address

3445 Executive Center Dr
Suite 250
Austin, TX 78731-1678
Phone (512) 579-4000

Other identifiers 1

IdentifierTypeStateIssuer
P090P9338MedicaidTX

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
I20100324000311 TX Practitioner - Pathology 0244319192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Baylor College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11111 Research Blvd
Austin, TX 78759-5264
Phone (512) 579-4000

1500 Red River St
Austin, TX 78701-1918
Phone (512) 579-4000

3445 Executive Ctr Dr
Suite 250
Austin, TX 78731-1678
Phone (512) 579-4000

Hospital & facility affiliations

  • Dell Seton Med Center at the University of TX Hospital, Austin, TX, CCN 450124
  • Ascension Seton Southwest Hospital, Austin, TX, CCN 450865
  • Ascension Seton Edgar B Davis Hospital, Luling, TX, CCN 451371

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J2137TXMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hurt, Jacknow, Moore, Connor, Wells, Michels, Yurco, Listrom & Huang Anatomic Pathology & Clinical Pathology CurrentSince Dec 28, 1992 Accepting new patients

Locations

3445 Executive Center Dr
Ste 250
Austin, TX 78731
Phone (512) 339-1275

601 E 15th St
Austin, TX 78701
Phone (512) 324-7868

4214 E Southcross Blvd
San Antonio, TX 78222
Phone (210) 297-3000

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

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.

Hospital & facility affiliations 4

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331251200000",
    "number": "1295790608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3445 EXECUTIVE CENTER DR",
            "address_2": "SUITE 250",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787311678",
            "telephone_number": "512-579-4000",
            "fax_number": "512-439-2814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3445 EXECUTIVE CENTER DR",
            "address_2": "SUITE 250",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787311678",
            "telephone_number": "512-579-4000",
            "fax_number": "512-439-2814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLDA",
        "first_name": "TIMOTHY",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2012-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "J2137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P090P9338",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.