Individual provider Active NPI

Albassi De Lima Tavares, APRN

  • Family Nurse Practitioner
  • Cedar Park, TX
National Provider Identifier
1417629122
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1048230 Issued in TX
Practice address
1401 Medical Pkwy Ste 200
Cedar Park, TX 78613-5026
Phone
(512) 260-1581
Fax
(512) 406-7309
NPI assigned
Sep 30, 2021
Last updated
Jan 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1048230 TX Primary

Addresses

Primary practice location

1401 Medical Pkwy Ste 200
Cedar Park, TX 78613-5026

Mailing address

6210 E Hwy 290
Austin, TX 78723-1142
Phone (512) 483-8586

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211207001652 TX Practitioner - Nurse Practitioner 6103216130 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Austin Regional Clinic PAGroup PAC ID 3072507789, 398 clinicians

Practice addresses (Care Compare)

12201 Renfert Way
250 Austin Regional Clinic North Austin OB/
Austin, TX 78758-5354
Phone (512) 994-2662

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1048230TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Regional Clinic, PA CurrentSince Nov 9, 2021 Accepting new patients
Austin Regional Clinic, PA CurrentSince Nov 9, 2021 Accepting new patients

Locations

12201 Renfert Way
Ste 250
Austin, TX 78758
Phone (512) 901-1506

6210 E Highway 290
Austin, TX 78723

6835 Austin Center Blvd
Austin, TX 78731
Phone (512) 231-5210

1401 Medical Pkwy
Ste 200
Cedar Park, TX 78613
Phone (512) 260-1581

1401 Medical Pkwy
Ste 220
Cedar Park, TX 78613
Phone (512) 260-1581

1401 Medical Pkwy
Ste 419
Cedar Park, TX 78613
Phone (512) 379-3636

151 Exchange Blvd
Ste 500
Hutto, TX 78634
Phone (512) 846-1244

Interoperability endpoints

  • Direct secure messaging: atavares26811@arcmd.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1632960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1417629122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 E HWY 290",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787231142",
            "telephone_number": "512-483-8586",
            "fax_number": "512-406-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MEDICAL PKWY STE 200",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786135026",
            "telephone_number": "512-260-1581",
            "fax_number": "512-406-7309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVARES",
        "first_name": "ALBASSI",
        "middle_name": "DE LIMA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-30",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1048230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

Verify at the official NPI Registry.