Individual provider Active NPI

Kristy M. Marsillo, DO

  • Emergency Medicine Physician
  • Austin, TX
National Provider Identifier
1508083346
Registry record updated Sep 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
N3868 Issued in TX
Practice address
La Costa Centre 6300 la Calma Drive
Suite 200
Austin, TX 78752-3825
Phone
(512) 452-8533
NPI assigned
Apr 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 58002101 OH
Emergency Medicine Physician 207P00000X N3868 TX Primary

Addresses

Primary practice location

La Costa Centre 6300 la Calma Drive
Suite 200
Austin, TX 78752-3825

Mailing address

1047 Sunflower TRL
Austin, TX 78745-2783
Phone (716) 465-2533

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
I20090722000364 TX Practitioner - Emergency Medicine 7719039775 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58002101OHMDEmergency Medicine Physician
N3868TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Critical Care Specialists PA CurrentSince Mar 1, 2020 Accepting new patients
Travis County Emergency Physicians PA Emergency Medicine CurrentSince Jan 1, 2018 Accepting new patients
Austin Critical Care Specialists PA CurrentSince Mar 1, 2020 Accepting new patients

Locations

6300 La Calma Dr
Ste 200
Austin, TX 78752
Phone (512) 610-0321

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

7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305

11113 Research Blvd
Austin, TX 78759
Phone (512) 324-1125

1201 W 38th St
Austin, TX 78705
Phone (512) 324-1058

1401 Medical Pkwy
Cedar Park, TX 78613
Phone (512) 528-7000

2615 Southwest Fwy
Ste 140
Houston, TX 77098
Phone (713) 441-2779

850 W Central Texas Expy
Killeen, TX 76548
Phone (254) 690-0900

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

1310 E League City Pkwy
League City, TX 77573
Phone (346) 427-5050

1751 Crystal Falls Pkwy
Leander, TX 78641
Phone (512) 528-7000

11525 Broadway St
Pearland, TX 77584
Phone (713) 363-8020

3011 W Loop 1604 N
San Antonio, TX 78251
Phone (726) 266-7081

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379462400000",
    "number": "1508083346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1047 SUNFLOWER TRL",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787452783",
            "telephone_number": "716-465-2533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LA COSTA CENTRE 6300 LA CALMA DRIVE",
            "address_2": "SUITE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787523825",
            "telephone_number": "512-452-8533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSILLO",
        "first_name": "KRISTY",
        "middle_name": "M.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2013-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "58002101",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "N3868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.