Individual provider Active NPI

Aileen A. Ebadat, M.D.

  • Surgery Physician
  • Austin, TX
National Provider Identifier
1306162805
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
Q4749 Issued in TX
Practice address
4310 James Casey St Ste 3C
Austin, TX 78745-1120
Phone
(512) 326-2800
Fax
(512) 441-6388
NPI assigned
Apr 9, 2010
Last updated
Mar 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X Q4749 TX
Surgery Physician 208600000X Q4749 TX Primary

Addresses

Primary practice location

4310 James Casey St Ste 3C
Austin, TX 78745-1120

Mailing address

4310 James Casey St Ste 3C
Austin, TX 78745-1120
Phone (512) 326-2800

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
I20160802001151 TX Practitioner - General SurgeryPractitioner - Other (Physician) 8820382633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Texas Medical Branch at Galveston, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Acute Care Surgery LLCGroup PAC ID 8729462981, 10 clinicians

Practice addresses (Care Compare)

4207 James Casey St
Suite 304
Austin, TX 78745-1193
Phone (512) 428-4441

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Acute Care Surgery LLC Surgery CurrentSince Mar 1, 2021 Accepting new patients
St. David's Healthcare Partnership, L.P., LLP Past Accepting new patients

Locations

4207 James Casey St
Ste 304
Austin, TX 78745
Phone (512) 402-5806

4310 James Casey St
Ste 3C
Austin, TX 78745
Phone (512) 244-0766

Interoperability endpoints

  • Direct secure messaging: aileen.ebadat.1@27482.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1270771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1306162805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 JAMES CASEY ST STE 3C",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451120",
            "telephone_number": "512-326-2800",
            "fax_number": "512-441-6388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 JAMES CASEY ST STE 3C",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451120",
            "telephone_number": "512-326-2800",
            "fax_number": "512-441-6388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBADAT",
        "first_name": "AILEEN",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-09",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "TX",
            "license": "Q4749",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "Q4749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.