NPIMap

Organization Active NPI

Texas Diabetes and Endocrinology, P.a.

  • Endocrinology, Diabetes & Metabolism Physician
  • Austin, TX
National Provider Identifier
1467427419
Registry record updated May 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
TEXAS DIABETES AND ENDOCRINOLOGY, P.A.
Practice address
6500 North Mo Pac Expressway
Building 3, Suite 200
Austin, TX 78731
Phone
(512) 458-8400
Fax
(512) 458-8593
NPI assigned
Feb 22, 2006
Last updated
May 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2008

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

Authorized official

Name
Tiffany Reichle
Title
Office Manager
Phone
(512) 458-8400

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU Primary
Physician Assistant 363A00000X TX
Clinical Nurse Specialist 364S00000X NU

Addresses

Primary practice location

6500 North Mo Pac Expressway
Building 3, Suite 200
Austin, TX 78731

Mailing address

6500 North Mo Pac Expressway
Building 3, Suite 200
Austin, TX 78731
Phone (512) 458-8400

Other identifiers 1

IdentifierTypeStateIssuer
710ROtherTXBCBS GROUP #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040223001206 TX Part B Supplier - Clinic/Group Practice 3577459031 Receives reassigned benefits from 27 practitioners
1 other NPI on this enrollment
Practice locations: Austin, TX; Round Rock, TX

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

5000 Davis Ln
Ste 200
Austin, TX 78749
Phone (512) 338-4500

110 Deer Ridge Dr
Round Rock, TX 78681
Phone (512) 458-8400

Practitioners & affiliated clinicians

Practitioners 35

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 35

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1467427419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 NORTH MO PAC EXPRESSWAY",
            "address_2": "BUILDING 3, SUITE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78731",
            "telephone_number": "512-458-8400",
            "fax_number": "512-458-8593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 NORTH MO PAC EXPRESSWAY",
            "address_2": "BUILDING 3, SUITE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78731",
            "telephone_number": "512-458-8400",
            "fax_number": "512-458-8593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS DIABETES AND ENDOCRINOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "REICHLE",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "512-458-8400"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP #",
            "identifier": "710R",
            "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 May 22, 2008; 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.