NPIMap

Organization Active NPI

Lone Star Circle of Care

Doing business as Lone Star Circle of Care @ Elgin

  • Family Medicine Physician
  • Elgin, TX
National Provider Identifier
1679905640
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
P4217 Issued in TX
Legal business name
LONE STAR CIRCLE OF CARE
Doing business as
Lone Star Circle of Care @ Elgin
Practice address
902 W 2ND St
Elgin, TX 78621-2515
Phone
(512) 626-0207
NPI assigned
Aug 1, 2013
Last updated
Aug 1, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
LONE STAR CIRCLE OF CAREAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

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

Authorized official

Name
Mr. Pete Perialas
Title
Ceo
Phone
51268680207

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 816106 TX
Clinical Social Worker 1041C0700X 51345 TX
Family Medicine Physician 207Q00000X P4217 TX Primary

Addresses

Primary practice location

902 W 2ND St
Elgin, TX 78621-2515

Mailing address

205 E University Ave
Suite 200
Georgetown, TX 78626-6814
Phone (512) 626-0207

Other names 1

  • Lone Star Circle of Care @ Elgin Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040622000184 TX Part B Supplier - Clinic/Group Practice 5193709392 Receives reassigned benefits from 181 practitioners
39 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Austin, TX; Taylor, TX; Round Rock, TX; Pflugerville, TX; Killeen, TX; Jonestown, TX; Hutto, TX; Harker Heights, TX…

Other NPIs on the same Medicare enrollment 39

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 39

National Provider Directory

National Provider Directory
Part of
LSCC Georgetown Pharmacy- Williams Drive

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375315200000",
    "number": "1679905640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E UNIVERSITY AVE",
            "address_2": "SUITE 200",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786266814",
            "telephone_number": "512-626-0207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 W 2ND ST",
            "city": "ELGIN",
            "state": "TX",
            "postal_code": "786212515",
            "telephone_number": "512-626-0207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONE STAR CIRCLE OF CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LONE STAR CIRCLE OF CARE",
        "enumeration_date": "2013-08-01",
        "last_updated": "2013-08-01",
        "status": "A",
        "authorized_official_last_name": "PERIALAS",
        "authorized_official_first_name": "PETE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "51268680207",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "816106",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "51345",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "P4217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lone Star Circle of Care @ Elgin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elgin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.