Individual provider Active NPI

Suzanne K Gazda, M.D.

  • Clinical Neurophysiology Physician
  • Boerne, TX
National Provider Identifier
1740286764
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X
License
H0527 Issued in TX
Practice address
1580 S Main St Ste 201
Boerne, TX 78006-3312
Phone
(210) 692-1245
Fax
(210) 692-9311
NPI assigned
Jun 23, 2005
Last updated
Jul 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X H0527 TX Primary

Addresses

Primary practice location

1580 S Main St Ste 201
Boerne, TX 78006-3312

Mailing address

PO Box 293879
Kerrville, TX 78029-3879
Phone (210) 692-1245

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20051101001006 TX Practitioner - Neurology 5395782320 Reassigns benefits to 2 organizations
I20200429000387 CO Practitioner - Neurology 5395782320

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Texas Medical School at San Antonio, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Neurology Institute of Kerrville PLLCGroup PAC ID 3678937687, 10 clinicians
Suzanne K. Gazda, MD, PLLCGroup PAC ID 0143267161, 6 clinicians

Practice addresses (Care Compare)

1580 S Main St
Suite 201
Boerne, TX 78006-3312
Phone (210) 692-1245

3603 Paesanos Pkwy
Suite 200
San Antonio, TX 78231-1269
Phone (210) 593-0776

3603 Paesanos Pkwy
Suite 300
San Antonio, TX 78231-1270

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Physician Assistant

State licenses

LicenseStateTypeSpecialty
H0527TXMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurology Institute of Kerrville PLLC CurrentSince Dec 1, 2022 Accepting new patients
Suzanne K. Gazda, MD, PLLC CurrentSince Aug 1, 1989 Accepting new patients
R. Braden Neiman, MD PA PastSince Sep 1, 2023 Accepting new patients

Locations

1580 S Main St
Ste 101B
Boerne, TX 78006
Phone (210) 692-1245

1580 S Main St
Ste 201
Boerne, TX 78006
Phone (210) 692-1245

1001 Water St
Ste J-100
Kerrville, TX 78028
Phone (830) 257-3131

3603 Paesanos Pkwy
Ste 200
San Antonio, TX 78231
Phone (210) 593-0776

3603 Paesanos Pkwy
Ste 300
San Antonio, TX 78231
Phone (210) 614-3011

Organizations & group practices 3

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 2

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": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1740286764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 293879",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780293879",
            "telephone_number": "210-692-1245",
            "fax_number": "210-692-9311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 S MAIN ST STE 201",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780063312",
            "telephone_number": "210-692-1245",
            "fax_number": "210-692-9311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAZDA",
        "first_name": "SUZANNE",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-23",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "TX",
            "license": "H0527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

Verify at the official NPI Registry.