Active NPI
Samuel Williams, DO, MBA
- Pediatrics Physician
- Austin, TX
National Provider Identifier
1750070819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- BP10083876
- Practice address
- 1501 Red River St FL 2
Austin, TX 78712-1845 - Phone
- (512) 495-5555
- NPI assigned
- May 4, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | BP10083876 | TX | Primary |
Addresses
Primary practice location
1501 Red River St FL 2
Austin, TX 78712-1845
Mailing address
1501 Red River St FL 2
Austin, TX 78712-1845
Phone (512) 495-5555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Kansas City College of Medicine and Surgery, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2115 Kramer LN
Austin, TX 78758-4197
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy, Master of Business Administration
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BP10083876 | TX | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683158400000",
"number": "1750070819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 RED RIVER ST FL 2",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787121845",
"telephone_number": "512-495-5555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 RED RIVER ST FL 2",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787121845",
"telephone_number": "512-495-5555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "SAMUEL",
"credential": "DO, MBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-04",
"last_updated": "2023-05-04",
"certification_date": "2023-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "BP10083876",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 May 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.