Individual provider Active NPI

Amethyst Guerrero, PT, DPT

  • Physical Therapist
  • Austin, TX
National Provider Identifier
1538684337
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1295381 Issued in TX
Practice address
12411 Hymeadow Dr Ste Bldg3
Austin, TX 78750-1874
Phone
(512) 335-9300
Fax
(512) 335-9301
NPI assigned
Aug 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1295381 TX Primary

Addresses

Primary practice location

12411 Hymeadow Dr Ste Bldg3
Austin, TX 78750-1874

Mailing address

12411 Hymeadow Dr. Ste
BLDG 3 Ste 3B
Austin, TX 78750
Phone (512) 335-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, UT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171017001369 TX Practitioner - Physical Therapist in Private Practice 5496021677 Reassigns benefits to 1 organization
I20250604002509 UT Practitioner - Physical Therapist in Private Practice 5496021677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Origin Physical Therapy FL PLLCGroup PAC ID 1759813348, 77 clinicians

Practice addresses (Care Compare)

12411 Hymeadow Dr
Austin, TX 78750-1874
Phone (213) 898-2673

455 E 200
Suite 110
Salt Lake City, UT 84111-2156
Phone (213) 898-2673

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Origin Physical Therapy FL PLLC Physical Therapist CurrentSince Oct 8, 2024 Accepting new patients

Locations

12411 Hymeadow Dr
Ste 3B
Austin, TX 78750
Phone (512) 250-8497

2712 Bee Caves Rd
Ste 122A
Austin, TX 78746
Phone (737) 234-9618

511 Oakwood Blvd
Ste 205
Round Rock, TX 78681
Phone (541) 610-5204

124 S 400 E
Ste 230
Salt Lake City, UT 84111
Phone (801) 597-5686

455 E 200 S
Ste 110
Salt Lake City, UT 84111
Phone (801) 359-4951

Organizations & group practices 1

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": "1502668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1538684337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12411 HYMEADOW DR. STE",
            "address_2": "BLDG 3 STE 3B",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78750",
            "telephone_number": "512-335-9300",
            "fax_number": "512-335-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12411 HYMEADOW DR STE BLDG3",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787501874",
            "telephone_number": "512-335-9300",
            "fax_number": "512-335-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRERO",
        "first_name": "AMETHYST",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1295381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.