NPIMap

Organization Active NPI

Synovation Medical Group Texas, PLLC

  • Pain Medicine Physician
  • Austin, TX
National Provider Identifier
1376145458
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
Legal business name
SYNOVATION MEDICAL GROUP TEXAS, PLLC
Practice address
3705 Medical Pkwy Ste 430
Austin, TX 78705-1023
Phone
(737) 256-5900
Fax
(737) 667-5011
NPI assigned
Nov 12, 2020
Last updated
Jul 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Authorized official

Name
Clayton Alexander Varga, MDNPI 1629060694
Title
President
Phone
(626) 696-1400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2081P2900X
Pain Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208VP0000X Primary

Addresses

Primary practice location

3705 Medical Pkwy Ste 430
Austin, TX 78705-1023

Mailing address

224 N Fair Oaks Ave Ste 300
Pasadena, CA 91103-3618
Phone (626) 696-1481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201222002532 TX Part B Supplier - Clinic/Group Practice 5597177287 Receives reassigned benefits from 5 practitioners
2 other NPIs on this enrollment
Practice locations: Wichita Falls, TX

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

224 N Fair Oaks Ave
Ste 300
Pasadena, CA 91103
Phone (626) 696-1451

3705 Medical Pkwy
Ste 430
Austin, TX 78705
Phone (512) 467-7770

11799 Beechnut St
Ste A
Houston, TX 77072
Phone (281) 575-7246

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1605139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625097600000",
    "number": "1376145458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 N FAIR OAKS AVE STE 300",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911033618",
            "telephone_number": "626-696-1481",
            "fax_number": "626-696-1451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 MEDICAL PKWY STE 430",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051023",
            "telephone_number": "737-256-5900",
            "fax_number": "737-667-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNOVATION MEDICAL GROUP TEXAS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-12",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A",
        "authorized_official_last_name": "VARGA",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-696-1400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; 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.