Active NPI
Michael F. Bardwil, M.D.
- Vascular Surgery Physician
- Houston, TX
National Provider Identifier
1689672594
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- G3131
- Practice address
- 13254 Forkland Drive
Houston, TX 77077-2301 - Phone
- (713) 461-4945
- Fax
- (713) 461-7677
- NPI assigned
- Jul 13, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | G3131 | TX | Primary |
Addresses
Primary practice location
13254 Forkland Drive
Houston, TX 77077-2301
Mailing address
13254 Forkland Drive
Houston, TX 77077
Phone (713) 461-4945
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8C0060 | Other | TX | BCBS |
| 081496401 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Surgical Associates of Houston, P.a. | Vascular Surgery | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Specialist
- Houston, TX
- NPI 1932387206
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321574400000",
"number": "1689672594",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13254 FORKLAND DRIVE",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77077",
"telephone_number": "713-461-4945",
"fax_number": "713-461-7677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13254 FORKLAND DRIVE",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770772301",
"telephone_number": "713-461-4945",
"fax_number": "713-461-7677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARDWIL",
"first_name": "MICHAEL",
"middle_name": "F.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-13",
"last_updated": "2011-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "TX",
"license": "G3131",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "8C0060",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "081496401",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.