Individual provider Active NPI

Phillip Levine, MD

  • Gastroenterology Physician
  • Round Rock, TX
National Provider Identifier
1619235660
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
Q4449 Issued in TX
Practice address
302 University Blvd
Round Rock, TX 78665-1032
Phone
(512) 509-0200
NPI assigned
Apr 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Q4449 TX
Gastroenterology Physician 207RG0100X Q4449 TX Primary

Addresses

Primary practice location

302 University Blvd
Round Rock, TX 78665-1032

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Other identifiers 1

IdentifierTypeStateIssuer
BP10044287OtherTXSCOTT AND WHITE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200514001527 IL Practitioner - Gastroenterology 6608122676 Reassigns benefits to 1 organization
I20251114002761 MA Practitioner - GastroenterologyPractitioner - Internal Medicine 6608122676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pratt Medical Group IncGroup PAC ID 3375515661, 282 clinicians

Practice addresses (Care Compare)

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.03 of 100Reported as group
Quality
71.53
Promoting interoperability
100
Improvement activities
40
Cost
76.89

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Medical Group, Inc Internal Medicine Current Accepting new patients
Mount Sinai Community Foundation CurrentSince Jun 1, 2020 Accepting new patients
Mount Sinai Community Foundation Internal Medicine CurrentSince Jun 1, 2020 Accepting new patients
Pratt Medical Group, Inc CurrentSince Dec 1, 2025 Accepting new patients
Pratt Medical Group, Inc CurrentSince Dec 1, 2025 Accepting new patients
Mount Sinai Community Foundation Current Accepting new patients
Pratt Medical Group, Inc Past Accepting new patients

Locations

26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900

1501 S California Ave
Chicago, IL 60608
Phone (773) 257-6770

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

800 Washington St
#1
Boston, MA 02111

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1619235660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 UNIVERSITY BLVD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651032",
            "telephone_number": "512-509-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVINE",
        "first_name": "PHILLIP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-27",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q4449",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "Q4449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SCOTT AND WHITE",
            "identifier": "BP10044287",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.