Individual provider Active NPI

Justin Givan

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1689026627
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
62450 Issued in TX
Practice address
5015 S Ih 35
Ste. 200D
Austin, TX 78744-2713
Phone
(512) 804-3685
NPI assigned
Jul 1, 2016
Last updated
Sep 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 62450 TX
Clinical Social Worker 1041C0700X 62450 TX Primary

Addresses

Primary practice location

5015 S Ih 35
Ste. 200D
Austin, TX 78744-2713

Mailing address

4603 Esper LN
Austin, TX 78725-2954
Phone (512) 318-8747

Other practice location 1

4115 E Lancaster Ave
Fort Worth, TX 76103-3614
Phone (817) 796-7370

Other names 1

  • Justin Givan-Gonzales Former name

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221108002517 TX Practitioner - Clinical Social Worker 6608243415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oak Street Health of Texas PLLCGroup PAC ID 2163843038, 103 clinicians

Practice addresses (Care Compare)

2360 Gus Thomasson Rd
Dallas, TX 75228-3005
Phone (314) 301-7071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
62450TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health of Texas, PLLC Clinical CurrentSince Aug 29, 2022 Accepting new patients

Locations

2360 Gus Thomasson Rd
Dallas, TX 75228
Phone (314) 301-7071

4115 E Lancaster Ave
Fort Worth, TX 76103
Phone (817) 796-7370

3500 Little York Rd
#A5
Houston, TX 77093
Phone (281) 707-7358

2115 S Broadway Ave
Tyler, TX 75701
Phone (903) 907-7002

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": "1467331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1689026627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4603 ESPER LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787252954",
            "telephone_number": "512-318-8747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 S IH 35",
            "address_2": "STE. 200D",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787442713",
            "telephone_number": "512-804-3685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4115 E Lancaster Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761033614",
            "country_code": "US",
            "telephone_number": "817-796-7370",
            "fax_number": "817-764-0714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIVAN",
        "first_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-01",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "62450",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "62450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUSTIN",
            "last_name": "GIVAN-GONZALES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.