NPIMap

Individual provider Active NPI

Samuel Asher Gorman, PAC

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1740571959
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA07191 Issued in TX
Practice address
11209 S Interstate 35
Austin, TX 78747-1712
Phone
(254) 724-2111
NPI assigned
Apr 21, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA07191 TX Primary

Addresses

Primary practice location

11209 S Interstate 35
Austin, TX 78747-1712

Mailing address

PO Box 847556
Dallas, TX 75284-7556

Other practice location 1

1402 W Avenue H
Temple, TX 76504-5342
Phone (254) 771-8411

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sgorman14115@direct.sw.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110624000594 TX Practitioner - Physician Assistant 3779761531 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

11209 S Interstate Hwy 35
Baylor Scott and White Clinic Onion
Austin, TX 78747-1712
Phone (512) 654-4700

1701 E Pflugerville Pkwy
Baylor Scott and White Clinic Pflug
Pflugerville, TX 78660-8990
Phone (512) 259-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA07191TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic CurrentSince Apr 18, 2024 Accepting new patients
Texas Em-1 Medical Services, PA Physician Assistant Past Accepting new patients
St. David'S Carenow Urgent Care PLLC Past Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients
Texas Emergency Room Services PA Past Accepting new patients

Locations

5000 W Slaughter Ln
Ste 100
Austin, TX 78749
Phone (512) 282-2273

1701 E Pflugerville Pkwy
Pflugerville, TX 78660
Phone (512) 259-6000

546 N Kegley Rd
Temple, TX 76502
Phone (254) 215-0900

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

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.

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": "1303344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1740571959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847556",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11209 S INTERSTATE 35",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787471712",
            "telephone_number": "254-724-2111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1402 W Avenue H",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765045342",
            "country_code": "US",
            "telephone_number": "254-771-8411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORMAN",
        "first_name": "SAMUEL",
        "middle_name": "ASHER",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-21",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgorman14115@direct.sw.org",
            "affiliation": "N",
            "address_1": "11209 S Interstate 35",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787471712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.