Gabriel Lewis Petty, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA06237 Issued in TX

Practice address

4611 Guadalupe St Ste 200
Austin, TX 78751-2928

Phone

(512) 476-2830

Fax

(512) 476-2832

NPI assigned

May 22, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, FL2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Synova HealthGroup PAC ID 8022557222, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Halcyon Home LLC Home health agency, Austin, TX, CCN 747931

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Synova Health

  • Orthopaedic Surgery Physician
  • West Lake Hills, TX
  • NPI 1407692817
  Medicare reassignment Care Compare group Authorized official
• Synova Wound Care

  • Physician Assistant
  • Palm Beach Gardens, FL
  • NPI 1164223749
  Medicare reassignment Authorized official
• Doctx3 PLLC

  • Orthopaedic Surgery Physician
  • Irving, TX
  • NPI 1467808618
  Medicare reassignment NPD
• Heinrich-Josey Orthopaedics, P.L.L.C

  dba Orthopaedic Specialists of Austin

  • Orthopaedic Surgery Physician
  • Austin, TX
  • NPI 1174571889
  Medicare reassignment NPD
• Heinrich-Josey Orthopaedics

  • Orthopaedic Surgery Physician
  • Leander, TX
  • NPI 1275330979
  NPD
• Austin Immediate Care, LLC

  • Emergency Care Clinic/Center
  • Austin, TX
  • NPI 1659522373
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Halcyon Home, LLC

  • Home Health Agency
  • Austin, TX
  • NPI 1003185059
  Care Compare affiliation

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

{
    "created_epoch": "1242950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1447485214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 GUADALUPE ST STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787512928",
            "telephone_number": "512-476-2830",
            "fax_number": "512-476-2832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 GUADALUPE ST STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787512928",
            "telephone_number": "512-476-2830",
            "fax_number": "512-476-2832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5329 Serene Hills Dr Ste 202",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787381259",
            "country_code": "US",
            "telephone_number": "512-476-2830",
            "fax_number": "512-476-2832",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "715 Discovery Blvd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Cedar Park",
            "state": "TX",
            "postal_code": "786132294",
            "country_code": "US",
            "telephone_number": "512-476-2830",
            "fax_number": "512-476-2832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTY",
        "first_name": "GABRIEL",
        "middle_name": "LEWIS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-22",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA06237",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie E Pettis, LCSW-S, LCDC
• Sarah Monroe Pettry, REGISTERED DIETITIAN
• Amela Rizvic Petty
• Bryn Petty, SLP
• Faraji Petty
• Gerald Bernard Pevow, DMD
• Pevzner DDS PLLC
• Alexandria Peynado
• Kathleen Pezan
• Margaret Pfaff

• 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 Jun 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.