Michael James Gdovin

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA17324 Issued in TX

Practice address

100 Hillcrest Medical Blvd
Waco, TX 76712-8897

Phone

(254) 202-2000

NPI assigned

Mar 18, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hillcrest Physician ServicesGroup PAC ID 1153304456, 114 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott & White Medical Center Hillcrest Hospital, Waco, TX, CCN 450101
• Baylor Scott & White Medical Center - Temple Hospital, Temple, TX, CCN 450054

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mgdovin1288733@direct.sw.org

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.

• Hillcrest Physician Services

  dba Baylor Scott & White Medical Center Hillcrest

  • Internal Medicine Physician
  • Waco, TX
  • NPI 1649294323
  Medicare reassignment Care Compare group
• Scott & White Clinic

  dba Baylor Scott & White Clinic - Temple

  • Internal Medicine Physician
  • Temple, TX
  • NPI 1093779704
  Medicare reassignment
• Scott & White Hospital - Taylor

  dba Baylor Scott & White Medical Center - Taylor

  • Emergency Medicine Physician
  • Taylor, TX
  • NPI 1659366557
  NPD (past)

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

• Hillcrest Baptist Medical Center

  dba Baylor Scott & White Medical Center Hillcrest

  • General Acute Care Hospital
  • Waco, TX
  • NPI 1891882833
  Care Compare affiliation
• Scott & White Memorial Hospital

  dba Baylor Scott & White Medical Center - Temple

  • General Acute Care Hospital
  • Temple, TX
  • NPI 1477516466
  Care Compare affiliation
• Scott & White Memorial Hospital

  dba Kings's Daughters Hospital- Scott & White Healthcare

  • General Acute Care Hospital
  • Temple, TX
  • NPI 1578502613
  Care Compare affiliation

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

{
    "created_epoch": "1647561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1497404420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HILLCREST MEDICAL BLVD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767128897",
            "telephone_number": "254-202-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 South University Drive",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "33328",
            "country_code": "US",
            "telephone_number": "954-262-1250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GDOVIN",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-18",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA17324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgdovin1288733@direct.sw.org",
            "affiliation": "N",
            "address_1": "100 Hillcrest Medical Blvd",
            "city": "Waco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "767128897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tiffany Nicole Gauthier
• Michelle Briana Gavinsky, MS, A-LPC
• Veronica Gaytan de la Rosa, LPC
• Lubna A Gazawi
• Winona Gbedey
• Ryan Thomas Gee, CRNA
• Taylor Runyan Gehring, D.D.S.
• Ethan Caleb Geiger, PA-C
• Joseph F Geiger, MD
• Nora Kathleen Geiger, M.ED., LPC

• Surgical Physician Assistant in Waco, TX
• Providers in Waco, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.