Individual provider Active NPI

Samantha Heather Dallefeld, M.D.

  • Pediatrics Physician
  • Austin, TX
National Provider Identifier
1477812659
Registry record updated May 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
BP1-0042809 Issued in TX
Practice address
4900 Mueller Blvd
Suite 3S.066C
Austin, TX 78723-3079
Phone
(512) 324-0165
NPI assigned
May 9, 2012
Last updated
May 9, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X BP1-0042809 TX Primary

Addresses

Primary practice location

4900 Mueller Blvd
Suite 3S.066C
Austin, TX 78723-3079

Mailing address

4900 Mueller Blvd
Suite 3S.066C
Austin, TX 78723-3079
Phone (512) 324-0165

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
I20181011002237 TX Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 4486906815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Critical Care (Intensivists)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dell Childrens Medical GroupGroup PAC ID 8224092978, 117 clinicians

Practice addresses (Care Compare)

1301 Barbara Jordan Blvd
Austin, TX 78723-3078

4900 Mueller Blvd
Austin, TX 78723-3051
Phone (512) 324-0000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP1-0042809TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dell Children's Medical Group CurrentSince Jun 8, 2023 Accepting new patients
Dell Children's Medical Group Pediatrics CurrentSince Jun 8, 2023 Accepting new patients
Ascension Seton Past Accepting new patients
Seton Family of Doctors Past Accepting new patients

Locations

1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800

4900 Mueller Blvd
Ste 3S66C
Austin, TX 78723
Phone (512) 324-0165

1000 Hesters Crossing Rd
Round Rock, TX 78681
Phone (512) 628-1800

Organizations & group practices 4

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": "1336521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336521600000",
    "number": "1477812659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 MUELLER BLVD",
            "address_2": "SUITE 3S.066C",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233079",
            "telephone_number": "512-324-0165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 MUELLER BLVD",
            "address_2": "SUITE 3S.066C",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233079",
            "telephone_number": "512-324-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLEFELD",
        "first_name": "SAMANTHA",
        "middle_name": "HEATHER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-09",
        "last_updated": "2012-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "BP1-0042809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.