Teresa R Kroeker MD PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

TERESA R KROEKER MD PA

Practice address

12319 N Mopac Expy
260
Austin, TX 78758-2414

Phone

(512) 491-0017

Fax

(512) 491-0063

NPI assigned

Mar 22, 2016

Organization subpart

No

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

Authorized official

Name

Teresa R Kroeker, MDNPI 1710084975

Title

President

Phone

(512) 491-0017

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13338/brand/1/csg/1/fhir/r4

Practitioners 1

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

• Teresa Ruth Kroeker, M.D.

  • Surgery Physician
  • Austin, TX
  • NPI 1710084975
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458604800000",
    "number": "1356703243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12319 N MOPAC EXPY",
            "address_2": "260",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787582414",
            "telephone_number": "512-491-0017",
            "fax_number": "512-491-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12319 N MOPAC EXPY",
            "address_2": "260",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787582414",
            "telephone_number": "512-491-0017",
            "fax_number": "512-491-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERESA R KROEKER MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-22",
        "last_updated": "2016-03-22",
        "status": "A",
        "authorized_official_last_name": "KROEKER",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-491-0017",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Pediatric Surgery",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teos Physician Group PLLC
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• Joanne Tercy
• Teddy Terhune
• Terra Psychiatry PLLC
• Brendan William Terranova, NASM CPT, CES, CNC
• Lauren Wiley Terrazas
• Lisa Terrazas, LPC

• Surgery Physician in Austin, TX
• Providers in Austin, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; 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.