Teresa Marie Boenig, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA07583 Issued in TX

Practice address

6300 La Calma Dr Ste 330
Austin, TX 78752-3843

Phone

(512) 374-9308

NPI assigned

Jan 23, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Lone Star Circle of Care

  dba Lone Star Circle of Care at Georgetown Dental

  • Federally Qualified Health Center (FQHC)
  • Georgetown, TX
  • NPI 1639129331
  NPD (past)

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1396016317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 LA CALMA DR STE 330",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787523843",
            "telephone_number": "512-374-9308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 LA CALMA DR STE 330",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787523843",
            "telephone_number": "512-374-9308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOENIG",
        "first_name": "TERESA",
        "middle_name": "MARIE",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-23",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2953101-02",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA07583",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laural Catherine Boeckman, LPC
• Jane Egan Boedeker-McDonnel, COTA
• Teresa Boehm, M.D.
• Karen Michelle Boeke, PHD
• Shane Kyle Boeker
• Ryan Boerner, M.D.
• Sheila D Boes, M.D.
• Brinna Boese
• Audrey Glenn Boettcher, RDN
• Anne Bogaev

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.