NPIMap

Individual provider Active NPI

Amanda Hartman Gavalas, MD

  • Family Medicine Physician
  • Georgetown, TX
National Provider Identifier
1356965743
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
U2217 Issued in TX
Practice address
2423 Williams Dr Ste 113
Georgetown, TX 78628-3269
Phone
(877) 800-5722
NPI assigned
Jun 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X U2217 TX
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X U2217 TX Primary

Addresses

Primary practice location

2423 Williams Dr Ste 113
Georgetown, TX 78628-3269

Mailing address

2423 Williams Dr Ste 107
Georgetown, TX 78628-3269
Phone (877) 800-5722

Other practice location 1

8061 Alameda Ave
El Paso, TX 79915-4705
Phone (915) 859-7545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250820003486 TX Practitioner - Family Practice 4284089319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Carolina School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lone Star Circle of CareGroup PAC ID 5193709392, 29 clinicians

Practice addresses (Care Compare)

2423 Williams Dr
Georgetown, TX 78628-3200
Phone (877) 800-5722

2423 Williams Dr
Suite 107
Georgetown, TX 78628-3269

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
U2217TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Lone Star Circle of Care CurrentSince Aug 18, 2025 Accepting new patients
Lone Star Circle of Care Family Medicine Current Accepting new patients
Lone Star Circle of Care CurrentSince Aug 18, 2025 Accepting new patients
Lone Star Circle of Care Past Accepting new patients

Locations

1221 W Ben White Blvd
Ste 200B
Austin, TX 78704
Phone (512) 524-9249

2423 Williams Dr
Ste 113
Georgetown, TX 78628
Phone (512) 863-9208

2423 Williams Dr
Ste 107
Georgetown, TX 78628
Phone (512) 686-0207

2423 Williams Dr
Georgetown, TX 78628
Phone (512) 341-8908

Interoperability endpoints

  • Direct secure messaging: amanda.hartman.gavalas.1@29821.direct.athenahealth.com

Organizations & group practices 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1356965743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 WILLIAMS DR STE 107",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283269",
            "telephone_number": "877-800-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2423 WILLIAMS DR STE 113",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786283269",
            "telephone_number": "877-800-5722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8061 Alameda Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799154705",
            "country_code": "US",
            "telephone_number": "915-859-7545",
            "fax_number": "915-859-9862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARTMAN GAVALAS",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-02",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "U2217",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "U2217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

Verify at the official NPI Registry.