Kimberly A Guajardo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10003 Issued in TX

Practice address

6000 S. Mopac Expressway, Suite 200
Austin, TX 78749

Phone

(512) 244-4272

NPI assigned

Aug 4, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mark Malone MD PAGroup PAC ID 2567369424, 102 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kimberly.guajardo.1@24201.direct.athenahealth.com

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.

• Mark Malone MD PA

  • Pain Medicine (Anesthesiology) Physician
  • Round Rock, TX
  • NPI 1407057250

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Mark Malone, MD PA

  • Pain Medicine (Anesthesiology) Physician
  • Killeen, TX
  • NPI 1982581427
  NPD

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1629454459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 S MAYS ST STE 201",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786647580",
            "telephone_number": "512-244-4272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 S. MOPAC EXPRESSWAY, SUITE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78749",
            "telephone_number": "512-244-4272"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 S Mays St",
            "address_2": "201",
            "address_purpose": "LOCATION",
            "city": "Round Rock",
            "state": "TX",
            "postal_code": "786647531",
            "country_code": "US",
            "telephone_number": "512-244-7242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUAJARDO",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-04",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "389739901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anita Guajardo, LCSW
• April M Guajardo, LCSW, LCDC
• Araceli Guajardo
• Britney Guajardo
• Jessica Rose Guajardo, MS, LPC
• Ryan Guajardo, LPC, LMFT-ASSOCIATE
• Sylvia Lee Guan, PHARMD
• Guardian Ride Services GRS LLC
• Deborah Guariguata, LCSW-ACP
• Tracy Jane Gubelin, RN, BSN, IBCLC

• Physician Assistant in Austin, TX
• Providers in Austin, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.