Organization Active NPI

Northstar Surgery Specialists, P.a.

  • Surgery Physician
  • Austin, TX
National Provider Identifier
1306083365
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
NORTHSTAR SURGERY SPECIALISTS, P.A.
Practice address
2217 Park Bend Dr Ste 220
Austin, TX 78758-5674
Phone
(512) 491-6542
Fax
(512) 491-0161
NPI assigned
Jan 13, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Authorized official

Name
Mieka Schambach
Title
Office Admin
Phone
(512) 491-6542

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

2217 Park Bend Dr Ste 220
Austin, TX 78758-5674

Mailing address

2217 Park Bend Dr Ste 220
Austin, TX 78758-5674
Phone (512) 491-6542

Other identifiers 1

IdentifierTypeStateIssuer
1306083365MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090327000308 TX Part B Supplier - Clinic/Group Practice 8729145206 Receives reassigned benefits from 2 practitioners
Practice locations: Austin, TX; Round Rock, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752537600000",
    "number": "1306083365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2217 PARK BEND DR STE 220",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585674",
            "telephone_number": "512-491-6542",
            "fax_number": "512-491-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 PARK BEND DR STE 220",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585674",
            "telephone_number": "512-491-6542",
            "fax_number": "512-491-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSTAR SURGERY SPECIALISTS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-13",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A",
        "authorized_official_last_name": "SCHAMBACH",
        "authorized_official_first_name": "MIEKA",
        "authorized_official_title_or_position": "OFFICE ADMIN",
        "authorized_official_telephone_number": "512-491-6542"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306083365",
            "state": "TX"
        }
    ],
    "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 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.