NPIMap

Organization Active NPI

Austin Endometriosis & Female Infertility Center PA

Doing business as Austin Endometriosis & Fertility Center PA

  • Gynecology Physician
  • Austin, TX
National Provider Identifier
1710085089
Registry record updated Oct 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
G2406 Issued in TX
Legal business name
AUSTIN ENDOMETRIOSIS & FEMALE INFERTILITY CENTER PA
Doing business as
Austin Endometriosis & Fertility Center PA
Practice address
4303 James Casey St
Suite a
Austin, TX 78145-1188
Phone
(512) 444-1414
Fax
(512) 444-5621
NPI assigned
Sep 20, 2006
Last updated
Oct 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2008

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

Authorized official

Name
Dr. Keikhosrow M Kavoussi, M.D.NPI 1013102904
Title
Owner
Phone
(512) 444-1414

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VE0102X G2406 TX
Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VG0400X G2406 TX Primary

Addresses

Primary practice location

4303 James Casey St
Suite a
Austin, TX 78145-1188

Mailing address

4303 James Casey St
Suite a
Austin, TX 78145-1188
Phone (512) 444-1414

Other names 1

  • Austin Endometriosis & Fertility Center PA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110419000943 TX Part B Supplier - Clinic/Group Practice 0648455592 Receives reassigned benefits from 1 practitioner
Practice locations: Austin, TX

National Provider Directory

National Provider Directory

Locations

4303 James Casey St
Austin, TX 78745

4303 James Casey St
Ste A
Austin, TX 78745
Phone (512) 444-1414

4303 James Casey St
Ste B
Austin, TX 78745
Phone (512) 444-1414

4303 James Casey St
Ste C
Austin, TX 78745

7700 Cat Hollow Dr
Ste 105
Round Rock, TX 78681
Phone (512) 501-2100

7700 Cat Hollow Dr
Ste 106
Round Rock, TX 78681
Phone (512) 444-1414

Practitioners & affiliated clinicians

Practitioners 6

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224720000000",
    "number": "1710085089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4303 JAMES CASEY ST",
            "address_2": "SUITE A",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "781451188",
            "telephone_number": "512-444-1414",
            "fax_number": "512-444-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4303 JAMES CASEY ST",
            "address_2": "SUITE A",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "781451188",
            "telephone_number": "512-444-1414",
            "fax_number": "512-444-5621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUSTIN ENDOMETRIOSIS & FEMALE INFERTILITY CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-10-23",
        "status": "A",
        "authorized_official_last_name": "KAVOUSSI",
        "authorized_official_first_name": "KEIKHOSROW",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-444-1414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "TX",
            "license": "G2406",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "TX",
            "license": "G2406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Austin Endometriosis & Fertility Center PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; 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.