NPIMap

Organization Active NPI

Pediatric Urology of Central Texas

  • Pediatric Urology Physician
  • Austin, TX
National Provider Identifier
1508932112
Registry record updated Apr 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Urology PhysicianTaxonomy code 2088P0231X
Legal business name
PEDIATRIC UROLOGY OF CENTRAL TEXAS
Practice address
1301 Barbara Jordan Blvd
Suite 302
Austin, TX 78723-3077
Phone
(512) 472-6134
Fax
(512) 472-1528
NPI assigned
Nov 27, 2006
Last updated
Apr 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2015

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

Authorized official

Name
George M Seremetis, MDNPI 1942202114
Title
Owner
Phone
(512) 472-6134

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2088P0231X Primary

Addresses

Primary practice location

1301 Barbara Jordan Blvd
Suite 302
Austin, TX 78723-3077

Mailing address

1301 Barbara Jordan Blvd
Suite 301
Austin, TX 78723-3077
Phone (512) 472-6134

Other names 1

  • Childrens Urology Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040106000417 TX Part B Supplier - Clinic/Group Practice 4587563887 Receives reassigned benefits from 9 practitioners
Practice locations: Austin, TX; Cedar Park, TX

National Provider Directory

National Provider Directory

Locations

1301 Barbara Jordan Blvd
Ste 301
Austin, TX 78723
Phone (512) 324-0918

1410 Ih 35 N
Ste 120
Austin, TX 78701
Phone (512) 472-6134

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428451200000",
    "number": "1508932112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD",
            "address_2": "SUITE 301",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233077",
            "telephone_number": "512-472-6134",
            "fax_number": "512-472-1528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD",
            "address_2": "SUITE 302",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233077",
            "telephone_number": "512-472-6134",
            "fax_number": "512-472-1528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC UROLOGY OF CENTRAL TEXAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2015-04-08",
        "status": "A",
        "authorized_official_last_name": "SEREMETIS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-472-6134",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2088P0231X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology, Pediatric Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Childrens Urology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Apr 8, 2015; 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.