Individual provider Active NPI

Nicholas Adam Stephens, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Austin, TX
National Provider Identifier
1306196522
Registry record updated Apr 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
P9006 Issued in TX
Practice address
4900 Mueller Blvd
Austin, TX 78723-3079
Phone
(855) 324-0091
Fax
(512) 380-7532
NPI assigned
Sep 14, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X P9006 TX Primary

Addresses

Primary practice location

4900 Mueller Blvd
Austin, TX 78723-3079

Mailing address

PO Box 845347
Dallas, TX 75284-5347
Phone (214) 645-7708

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
I20180503001071 TX Practitioner - Thoracic Surgery 9436413283 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
University of Texas Medical School at Houston, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shannon ClinicGroup PAC ID 0840103727, 550 clinicians

Practice addresses (Care Compare)

102 N Magdalen
San Angelo, TX 76903
Phone (325) 747-1511

Hospital & facility affiliations

  • Shannon Medical Center Hospital, San Angelo, TX, CCN 450571

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children'S Physician Group CurrentSince Oct 8, 2018 Accepting new patients
Shannon Clinic CurrentSince Jan 1, 2025 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Mar 12, 2018 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Mar 12, 2018 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients

Locations

8611 N Mopac Expy
Austin, TX 78759
Phone (713) 816-1250

4900 Mueller Blvd
Austin, TX 78723
Phone (512) 324-0165

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511

102 N Magdalen St
San Angelo, TX 76903
Phone (325) 655-2200

6651 Main St
Va Hospital, TX 77030
Phone (832) 826-3000

Organizations & group practices 5

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 1

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": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524441600000",
    "number": "1306196522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-645-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 MUELLER BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233079",
            "telephone_number": "855-324-0091",
            "fax_number": "512-380-7532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "NICHOLAS",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-14",
        "last_updated": "2018-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "P9006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.