Individual provider Active NPI

Tracy Rodriguez Lama-Briseno, D.O.

  • Pediatrics Physician
  • Austin, TX
National Provider Identifier
1558520544
Registry record updated Mar 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
P0078 Issued in TX
Practice address
1210 W Braker LN
Austin, TX 78758-3801
Phone
(512) 978-9300
Fax
(512) 279-2556
NPI assigned
Jun 4, 2008
Last updated
Mar 10, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X BP1-0032382 TX
Pediatrics Physician 208000000X P0078 TX Primary

Addresses

Primary practice location

1210 W Braker LN
Austin, TX 78758-3801

Mailing address

1210 W Braker LN
Austin, TX 78758-3801
Phone (512) 978-9300

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
I20201109000293 TX Practitioner - Pediatric Medicine 5092971424 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P0078TXMDEmergency Medicine Physician
BP1-0032382TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Healthcare Associates, PLLC Pediatrics CurrentSince Sep 1, 2020 Accepting new patients
Northeast Pediatric Associates PA Pediatrics PastSince Sep 1, 2020 Accepting new patients

Locations

1139 E Sonterra Blvd
#205
San Antonio, TX 78258
Phone (210) 614-2229

1139 E Sonterra Blvd
Ste 205
San Antonio, TX 78258
Phone (210) 614-2229

1355 Central Pkwy S
Ste 400
San Antonio, TX 78232
Phone (210) 349-9300

14100 San Pedro Ave
Ste 200
San Antonio, TX 78232

8606 Village Dr
#A
San Antonio, TX 78217
Phone (210) 657-0220

5000 Schertz Pkwy
Ste 202
Schertz, TX 78154
Phone (210) 651-1055

18772 Forty Six Pkwy
Bldg 5
Spring Branch, TX 78070
Phone (210) 692-3636

Interoperability endpoints

  • Direct secure messaging: tlama@npa.pcc-direct.com

Organizations & group practices 2

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": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489104000000",
    "number": "1558520544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 W BRAKER LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787583801",
            "telephone_number": "512-978-9300",
            "fax_number": "512-279-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 W BRAKER LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787583801",
            "telephone_number": "512-978-9300",
            "fax_number": "512-279-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMA-BRISENO",
        "first_name": "TRACY",
        "middle_name": "RODRIGUEZ",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-04",
        "last_updated": "2017-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "BP1-0032382",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P0078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.