Individual provider Active NPI

Liridona Halili

  • Physician Assistant
  • Georgetown, TX
National Provider Identifier
1720639404
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16300 Issued in TX
Practice address
900 N Austin Ave Ste 105
Georgetown, TX 78626-4349
Phone
(512) 630-7828
NPI assigned
Sep 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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 8701 AZ
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA16300 TX Primary

Addresses

Primary practice location

900 N Austin Ave Ste 105
Georgetown, TX 78626-4349

Mailing address

9494 W Northern Ave
Glendale, AZ 85305-1118

Other practice location 1

9494 W Northern Ave
Glendale, AZ 85305-1118
Phone (623) 872-2226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20211221001393 AZ Practitioner - Physician Assistant 4486045770 Reassigns benefits to 2 organizations
I20230127001776 TX Practitioner - Physician Assistant 4486045770 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ucp Physicians of Central Texas, PLLC CurrentSince Nov 29, 2022 Accepting new patients
Primamed Physicians PLLC CurrentSince Nov 29, 2022 Accepting new patients
Citimed, P.a. Past Accepting new patients

Locations

4401 Little Rd
Ste 520
Arlington, TX 76016
Phone (682) 318-3114

6001 W William Cannon Dr
Ste 302
Austin, TX 78749
Phone (512) 288-3627

11888 Marsh Ln
Ste 104
Dallas, TX 75234
Phone (972) 488-9222

900 N Austin Ave
Ste 105
Georgetown, TX 78626
Phone (512) 930-1025

1331 Northpark Dr
Kingwood, TX 77339
Phone (281) 359-5330

3304 Alma Dr
Plano, TX 75023
Phone (972) 424-6581

1240 E Palm Valley Blvd
Round Rock, TX 78664
Phone (512) 733-9100

Interoperability endpoints

  • Direct secure messaging: liridona.halilipac.p14@direct.nextcare.nextgenshare.com
  • Direct secure messaging: liridona.halilipac.p1@direct.nextcare.nextgenshare.com
  • Direct secure messaging: liridona.halilipac.p11@direct.nextcare.nextgenshare.com
  • Direct secure messaging: liridona.halilipac.p6@direct.nextcare.nextgenshare.com

Organizations & group practices 8

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": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1720639404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9494 W NORTHERN AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853051118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N AUSTIN AVE STE 105",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786264349",
            "telephone_number": "512-630-7828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9494 W Northern Ave",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "AZ",
            "postal_code": "853051118",
            "country_code": "US",
            "telephone_number": "623-872-2226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALILI",
        "first_name": "LIRIDONA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-24",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8701",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA16300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

Verify at the official NPI Registry.