NPIMap

Organization Active NPI

Everly Provider Group de, P.a.

  • General Practice Physician
  • Austin, TX
National Provider Identifier
1457112773
Registry record updated Nov 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
EVERLY PROVIDER GROUP DE, P.A.
Practice address
5209 Burnet Rd
Austin, TX 78756-2442
Phone
(888) 813-0218
NPI assigned
Jan 23, 2024
Last updated
Nov 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2025

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

Authorized official

Name
Saba HaqNPI 1669460085
Title
Ao
Phone
(949) 463-0650

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
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

5209 Burnet Rd
Austin, TX 78756-2442

Mailing address

5209 Burnet Rd
Austin, TX 78756-2442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, NC, MS, TX, TN, FL, MI, IL, GA9 enrollments

Enrollment records 9

Enrollment IDStateProvider typePAC IDDetails
O20240820001669 LA Part B Supplier - Clinic/Group Practice 7113464470 Receives reassigned benefits from 1 practitioner
Practice locations: Baton Rouge, LA
O20241218000740 NC Part B Supplier - Clinic/Group Practice 7113464470 Receives reassigned benefits from 1 practitioner
Practice locations: Lowgap, NC
O20251201001169 MS Part B Supplier - Clinic/Group Practice 7113464470 Practice locations: Cleveland, MS
O20251202000595 TX Part B Supplier - Clinic/Group Practice 7113464470 Receives reassigned benefits from 2 practitioners
Practice locations: Fort Worth, TX
O20251205000461 TN Part B Supplier - Clinic/Group Practice 7113464470 Practice locations: Kingsport, TN
O20251218000818 FL Part B Supplier - Clinic/Group Practice 7113464470 Receives reassigned benefits from 3 practitioners
Practice locations: Coral Gables, FL; Wellington, FL; Plantation, FL; Hialeah Gardens, FL
O20251219001071 MI Part B Supplier - Clinic/Group Practice 7113464470 Receives reassigned benefits from 1 practitioner
Practice locations: Ann Arbor, MI; Clarkston, MI
O20260213003002 IL Part B Supplier - Clinic/Group Practice 7113464470 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL
O20260220003724 GA Part B Supplier - Clinic/Group Practice 7113464470 Receives reassigned benefits from 2 practitioners
Practice locations: Atlanta, GA; Lawrenceville, GA

National Provider Directory

National Provider Directory

Locations

9116 Forest Hill Blvd
Fl Tele
Wellington, FL 33411

Practitioners & affiliated clinicians

Practitioners 12

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": "1705968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762905600000",
    "number": "1457112773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5209 BURNET RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787562442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5209 BURNET RD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787562442",
            "telephone_number": "888-813-0218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERLY PROVIDER GROUP DE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-23",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A",
        "authorized_official_last_name": "HAQ",
        "authorized_official_first_name": "SABA",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "949-463-0650"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "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 Nov 12, 2025; 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.