Individual provider Active NPI

Priti P Gopal

  • Acute Care Nurse Practitioner
  • Austin, TX
National Provider Identifier
1700544053
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1151430 Issued in TX
Practice address
1108 Lavaca St
Austin, TX 78701-2172
Phone
(512) 477-4088
NPI assigned
Dec 3, 2021
Last updated
Jan 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1151430 TX Primary

Addresses

Primary practice location

1108 Lavaca St
Austin, TX 78701-2172

Mailing address

1108 Lavaca St
Austin, TX 78701-2172

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250108000145 TX Practitioner - Nurse Practitioner 6901334739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Austin Geriatric Specialists PLLCGroup PAC ID 5092770511, 59 clinicians

Practice addresses (Care Compare)

11406 Rustic Rock Dr
Austin, TX 78750-3505
Phone (512) 477-4088

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Geriatric Specialists, PLLC CurrentSince Jan 10, 2025 Accepting new patients

Locations

1108 Lavaca St
Ste 110320
Austin, TX 78701
Phone (512) 482-0390

11406 Rustic Rock Dr
Austin, TX 78750
Phone (512) 251-3915

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18292/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/25850/brand/1/csg/1/fhir/r4
  • Direct secure messaging: priti.gopal.1@25850.direct.athenahealth.com

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1638489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1700544053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 LAVACA ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787012172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 LAVACA ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787012172",
            "telephone_number": "512-477-4088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOPAL",
        "first_name": "PRITI",
        "middle_name": "P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-03",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1151430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.