Individual provider Active NPI

Allen Nicholas Jarzombek, MD

  • Family Medicine Physician
  • Bastrop, TX
National Provider Identifier
1306257738
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
S3000 Issued in TX
Practice address
3101 Highway 71 E Ste 101
Bastrop, TX 78602-5159
Phone
(512) 304-0300
Fax
(855) 270-9668
NPI assigned
May 20, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X S3000 TX Primary
Family Medicine Physician 207Q00000X 35152 AL

Addresses

Primary practice location

3101 Highway 71 E Ste 101
Bastrop, TX 78602-5159

Mailing address

5625 Eiger Rd Ste 200
Austin, TX 78735-8982
Phone (512) 892-7076

Other identifiers 1

IdentifierTypeStateIssuer
1306257738MedicaidTX

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
I20191004002021 TX Practitioner - Family Practice 3870850902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical Branch at Galveston, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Austin Family Practice Clinic, PLLCGroup PAC ID 3678564358, 64 clinicians

Practice addresses (Care Compare)

912 S Capital of Texas Hwy 100
Premier Family Physicians
West Lake Hills, TX 78746-5242
Phone (512) 892-7076

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35152ALMDFamily Medicine Physician
S3000TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Austin Family Practice Clinic, PLLC Family Medicine CurrentSince Sep 4, 2019 Accepting new patients

Locations

5625 Eiger Rd
Ste 2
Austin, TX 78735

5625 Eiger Rd
Ste 200
Austin, TX 78735

3101 Highway 71 E
Ste 101
Bastrop, TX 78602
Phone (512) 304-0300

170 Benney Ln
Ste 200
Dripping Springs, TX 78620
Phone (512) 858-2997

912 S Capital of Texas Hwy
Ste 100
West Lake Hills, TX 78746
Phone (512) 306-8360

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 3

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": "1400544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1306257738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5625 EIGER RD STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787358982",
            "telephone_number": "512-892-7076",
            "fax_number": "855-270-9668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 HIGHWAY 71 E STE 101",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786025159",
            "telephone_number": "512-304-0300",
            "fax_number": "855-270-9668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARZOMBEK",
        "first_name": "ALLEN",
        "middle_name": "NICHOLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-20",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S3000",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "35152",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306257738",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bastrop, TX

Sources for this page

Verify at the official NPI Registry.