Organization Active NPI

Tracy Byerly II MD PA

  • Otolaryngology Physician
  • Fredericksburg, TX
National Provider Identifier
1689142127
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
TRACY BYERLY II MD PA
Practice address
205 W Windcrest St Ste 210
Fredericksburg, TX 78624-4480
Phone
(830) 997-4000
Fax
(830) 997-2028
NPI assigned
Nov 2, 2018
Organization subpart
Yes
Parent organization
TRACY BYERLY II, MD PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Authorized official

Name
Katie Durham
Title
Billing Coordinator
Phone
(830) 997-4000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary
Clinic/Center 261Q00000X

Addresses

Primary practice location

205 W Windcrest St Ste 210
Fredericksburg, TX 78624-4480

Mailing address

205 W Windcrest St Ste 210
Fredericksburg, TX 78624-4480
Phone (830) 997-4000

Other practice location 1

500 Thompson Dr
Kerrville, TX 78028-5144
Phone (830) 997-4000 ext. 2057

Other identifiers 1

IdentifierTypeStateIssuer
1427354208OtherTXBCBS

Other names 1

  • Sinus ENT Center of Texas Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190607002553 TX Part B Supplier - Clinic/Group Practice 4082947999 Receives reassigned benefits from 3 practitioners
Practice locations: Boerne, TX; Kerrville, TX; Fredericksburg, TX

National Provider Directory

National Provider Directory
Part of
Tracy Byerly II MD PA

Locations

205 W Windcrest Dr
Ste 210
Fredericksburg, TX 78624

811 S Milam St
Fredericksburg, TX 78624
Phone (314) 604-4618

500 Thompson Dr
Ste 1
Kerrville, TX 78028
Phone (830) 997-4000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JDDGBD

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1541116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1689142127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W WINDCREST ST STE 210",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786244480",
            "telephone_number": "830-997-4000",
            "fax_number": "830-997-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W WINDCREST ST STE 210",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786244480",
            "telephone_number": "830-997-4000",
            "fax_number": "830-997-2028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Thompson Dr",
            "address_purpose": "LOCATION",
            "city": "Kerrville",
            "state": "TX",
            "postal_code": "780285144",
            "country_code": "US",
            "telephone_number": "830-997-4000 x2057",
            "fax_number": "830-997-2028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRACY BYERLY II MD PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRACY BYERLY II, MD PA",
        "enumeration_date": "2018-11-02",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "DURHAM",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "830-997-4000"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1427354208",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sinus ENT Center of Texas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fredericksburg, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.