NPIMap

Organization Active NPI

Austin Geriatric Specialists, PLLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Austin, TX
National Provider Identifier
1376575886
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
AUSTIN GERIATRIC SPECIALISTS, PLLC
Practice address
12731 Research Blvd Ste B200
Austin, TX 78759
Phone
(877) 856-3774
Fax
(512) 482-0390
NPI assigned
Jul 7, 2006
Last updated
Feb 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Authorized official

Name
Dr. Liam M Fry, MDNPI 1952322570
Title
Owner
Phone
(877) 856-3774

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X NU Primary

Addresses

Primary practice location

12731 Research Blvd Ste B200
Austin, TX 78759

Mailing address

1108 Lavaca St Ste 110-320
Austin, TX 78701-2172
Phone (877) 856-3774

Other identifiers 4

IdentifierTypeStateIssuer
00049FOtherTXBCBS OF TEXAS
CI5689OtherTXTRAVELERS/MEDICARE RAILROAD
079678101MedicaidTX
CG1751OtherTXMEDICARE RAILROAD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041124000120 TX Part B Supplier - Clinic/Group Practice 5092770511 Receives reassigned benefits from 148 practitioners
Practice locations: Austin, TX; Round Rock, TX; Pflugerville, TX; Marble Falls, TX; Kyle, TX

National Provider Directory

National Provider Directory

Locations

1108 Lavaca St
#110320
Austin, TX 78701
Phone (512) 674-9003

1108 Lavaca St
Ste 110320
Austin, TX 78701
Phone (512) 482-0390

1201 W 38th St
Austin, TX 78705
Phone (512) 324-1058

12731 Research Blvd
Ste B200
Austin, TX 78759
Phone (512) 407-4088

1301 W 38th St
Ste 420
Austin, TX 78705

1313 Red River St
#303
Austin, TX 78701
Phone (208) 757-9204

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/25850/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 164

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.

View all 164

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708041600000",
    "number": "1376575886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 LAVACA ST STE 110-320",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787012172",
            "telephone_number": "877-856-3774",
            "fax_number": "239-599-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12731 RESEARCH BLVD STE B200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78759",
            "telephone_number": "877-856-3774",
            "fax_number": "512-482-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUSTIN GERIATRIC SPECIALISTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A",
        "authorized_official_last_name": "FRY",
        "authorized_official_first_name": "LIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "877-856-3774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "00049F",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS/MEDICARE RAILROAD",
            "identifier": "CI5689",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079678101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CG1751",
            "state": "TX"
        }
    ],
    "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 Feb 16, 2024; 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.