Individual provider Active NPI

Paul William John

  • Family Medicine Physician
  • Austin, TX
National Provider Identifier
1679681357
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J0887 Issued in TX
Practice address
11671 Jollyville Rd
Suite 202
Austin, TX 78759-4139
Phone
(512) 343-9848
Fax
(512) 346-6492
NPI assigned
Aug 25, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X J0887 TX Primary

Addresses

Primary practice location

11671 Jollyville Rd
Suite 202
Austin, TX 78759-4139

Mailing address

11671 Jollyville Rd
Suite 202
Austin, TX 78759-4139
Phone (512) 343-9848

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
I20040830000387 TX Practitioner - Family Practice 4183699564 Practice locations: Austin, TX

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at San Antonio, 1989
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5929 Balcones Dr
Suite 200
Austin, TX 78731-4216

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D9619TXMDFamily Medicine Physician
J0887TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dose Management PA Past Accepting new patients

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679681357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11671 JOLLYVILLE RD",
            "address_2": "SUITE 202",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594139",
            "telephone_number": "512-343-9848",
            "fax_number": "512-346-6492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11671 JOLLYVILLE RD",
            "address_2": "SUITE 202",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594139",
            "telephone_number": "512-343-9848",
            "fax_number": "512-346-6492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "PAUL",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J0887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.