Individual provider Active NPI

Elizabeth Rebecca Geddes-Bruce, M.D.

  • Dermatology Physician
  • Austin, TX
National Provider Identifier
1306166152
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
Q0259 Issued in TX
Practice address
3637 Far West Blvd Ste E
Austin, TX 78731-4126
Phone
(512) 615-2737
Fax
(512) 379-7204
NPI assigned
Jun 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X Q0259 TX Primary

Addresses

Primary practice location

3637 Far West Blvd Ste E
Austin, TX 78731-4126

Mailing address

3637 Far West Blvd Ste E
Austin, TX 78731-4126
Phone (512) 615-2737

Other names 1

  • Ms. Elizabeth Rebecca Geddes Former name

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
I20141224000061 TX Practitioner - Dermatology 0244553238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Texas Medical School at Houston, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westlake Dermatology PAGroup PAC ID 6305817230, 52 clinicians

Practice addresses (Care Compare)

3637 Far W Blvd
Suite E
Austin, TX 78731-4126
Phone (512) 615-2737

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions133
Skin biopsy49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q0259TXMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westlake Dermatology, PA Dermatology CurrentSince Sep 1, 2016 Accepting new patients
Westlake Dermatology PA Dermatology Current Accepting new patients
Westlake Dermatology, PA Dermatology CurrentSince Sep 1, 2016 Accepting new patients

Locations

12201 Renfert Way
Ste 305
Austin, TX 78758
Phone (513) 279-3376

3800 N Lamar Blvd
Ste 155
Austin, TX 78756
Phone (512) 617-9200

8825 FM 2244 Rd
Ste 100
Austin, TX 78746

3637 Far West Blvd
Ste E
Austin, TX 78731
Phone (512) 615-2737

401 S FM 620 Rd
Ste 200
Lakeway, TX 78734
Phone (512) 610-0549

1760 Round Rock Ave
Round Rock, TX 78681
Phone (512) 583-3376

Organizations & group practices 3

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": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572825600000",
    "number": "1306166152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3637 FAR WEST BLVD STE E",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314126",
            "telephone_number": "512-615-2737",
            "fax_number": "512-379-7204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3637 FAR WEST BLVD STE E",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314126",
            "telephone_number": "512-615-2737",
            "fax_number": "512-379-7204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEDDES-BRUCE",
        "first_name": "ELIZABETH",
        "middle_name": "REBECCA",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2019-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "Q0259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "GEDDES",
            "middle_name": "REBECCA",
            "prefix": "MS.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.