Individual provider Active NPI

Crystal Marie Salazar, P.A.

  • Physician Assistant
  • Lakeway, TX
National Provider Identifier
1710139308
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA05947 Issued in TX
Practice address
2306 Ranch Road 620 S
Lakeway, TX 78734-6269
Phone
(512) 263-6000
NPI assigned
Oct 15, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TX
Medical Physician Assistant 363AM0700X PA05947 TX
Physician Assistant 363A00000X PA05947 TX Primary

Addresses

Primary practice location

2306 Ranch Road 620 S
Lakeway, TX 78734-6269

Mailing address

5929 Balcones Dr
Ste 200
Austin, TX 78731-4280
Phone (512) 550-1800

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
I20120814000361 TX Practitioner - Physician Assistant 9931355583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Texas Tech University Health Science Center School of Medicine, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Sinus and Allergy Specialists of TexasGroup PAC ID 7315169596, 41 clinicians

Practice addresses (Care Compare)

115 N Loop 1604 E
1204 Texan Allergy
San Antonio, TX 78232-1399
Phone (512) 550-1800

401 W Slaughter LN
Suite 300
Austin, TX 78748-1774
Phone (512) 550-1800

5929 Balcones Dr
Suite 200
Austin, TX 78731-4216

7125 New Sanger Ave
504 Texan Allergy
Waco, TX 76712-4054
Phone (512) 550-1800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA05947TXMDMedical Physician Assistant

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669593600000",
    "number": "1710139308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5929 BALCONES DR",
            "address_2": "STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314280",
            "telephone_number": "512-550-1800",
            "fax_number": "512-233-5338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2306 RANCH ROAD 620 S",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787346269",
            "telephone_number": "512-263-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALAZAR",
        "first_name": "CRYSTAL",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-15",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA05947",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeway, TX

Sources for this page

Verify at the official NPI Registry.