Individual provider Active NPI

Diana Nathalie Andino

  • Neurology Physician
  • Austin, TX
National Provider Identifier
1467957779
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
T4882 Issued in TX
Practice address
11714 Wilson Parke Ave Ste 150
Austin, TX 78726-4061
Phone
(737) 247-7200
NPI assigned
Mar 28, 2018
Last updated
Jul 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 125.072050 IL
Student in an Organized Health Care Education/Training Program 390200000X IL
Neurology Physician 2084N0400X T4882 TX Primary

Addresses

Primary practice location

11714 Wilson Parke Ave Ste 150
Austin, TX 78726-4061

Mailing address

6210 E Hwy 290 Ste 240
Austin, TX 78723-1144

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220718000088 TX Practitioner - Neurology 5496004053 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Loyola University of Chicago, Stritch School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Austin Regional Clinic PAGroup PAC ID 3072507789, 398 clinicians

Practice addresses (Care Compare)

11714 Wilson Parke Ave
Suite 150
Austin, TX 78726-4061
Phone (737) 247-7200

6835 Austin Ctr Blvd
Austin, TX 78731-3166
Phone (512) 346-6611

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Regional Clinic, PA CurrentSince Jul 11, 2023 Accepting new patients
The University of Texas at Austin CurrentSince Jul 1, 2022 Accepting new patients
Austin Regional Clinic, PA CurrentSince Jul 11, 2023 Accepting new patients
Loyola University Medical Center Current Accepting new patients
University of Texas at Austin Dell Medical School Current Accepting new patients
University of Texas at Austin Dell Medical School CurrentSince Jul 1, 2022 Accepting new patients

Locations

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

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

1601 Trinity St
Stop Z0200
Austin, TX 78712
Phone (512) 495-5512

1601 Trinity St
Austin, TX 78712
Phone (833) 882-2737

11714 Wilson Parke Ave
Ste 150
Austin, TX 78726
Phone (512) 346-6611

6210 E Highway 290
Ste 240
Austin, TX 78723

1601 Trinity St
Ste Z700
Austin, TX 78712

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

Interoperability endpoints

  • Direct secure messaging: dandino60303@direct.luhs.org
  • Direct secure messaging: dandino28325@arcmd.direct-ci.com

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1467957779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 E HWY 290 STE 240",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787231144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11714 WILSON PARKE AVE STE 150",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787264061",
            "telephone_number": "737-247-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDINO",
        "first_name": "DIANA",
        "middle_name": "NATHALIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-28",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "125.072050",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "T4882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.