Individual provider Active NPI

Deborah Ceresa, PA

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1619130440
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA08544 Issued in TX
Practice address
10001 S Ih 35
Austin, TX 78747-1701
Phone
(512) 440-0555
Fax
(512) 448-1113
NPI assigned
Jul 2, 2008
Last updated
Jul 21, 2022By the provider in NPPES
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
Physician Assistant 363A00000X PA08544 TX Primary

Addresses

Primary practice location

10001 S Ih 35
Austin, TX 78747-1701

Mailing address

10001 S Ih 35
Austin, TX 78747-1701
Phone (512) 440-0555

Other identifiers 1

IdentifierTypeStateIssuer
PA9104410OtherFLMEDICAL LICENSE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140122000314 TX Practitioner - Physician Assistant 0941374763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

106 Overlook PT
Dallas, GA 30157-7416

208 Bella Colinas Dr
Austin, TX 78738-7631

3102 Neal St
Austin, TX 78702-3046

3663 N Sam Houston Pkwy E
Suite 600
Houston, TX 77032-3611

4495 Wandering Vine TRL
Round Rock, TX 78665-1266

5080 Spectrum Dr
Suite 1200W
Addison, TX 75001-6443

5901 W Century Blvd
Suite 750
Los Angeles, CA 90045-5443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Arolaeh Inc CurrentSince Dec 20, 2025 Accepting new patients

Locations

3663 N Sam Houston Pkwy E
Ste 600
Houston, TX 77032
Phone (281) 594-8953

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, 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": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1619130440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10001 S IH 35",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787471701",
            "telephone_number": "512-440-0555",
            "fax_number": "512-448-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10001 S IH 35",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787471701",
            "telephone_number": "512-440-0555",
            "fax_number": "512-448-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERESA",
        "first_name": "DEBORAH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PA9104410",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.