Individual provider Active NPI

Paul Ellis Bristol, MD

  • Family Medicine Physician
  • Austin, TX
National Provider Identifier
1780760595
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G9265 Issued in TX
Practice address
4201 W Parmer LN Ste A250
Austin, TX 78727-4115
Phone
(512) 799-1345
Fax
(844) 445-6850
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G9265 TX Primary

Addresses

Primary practice location

4201 W Parmer LN Ste A250
Austin, TX 78727-4115

Mailing address

4201 W Parmer LN Ste A250
Austin, TX 78727-4115
Phone (512) 799-1345

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120822000581 TX Practitioner - Family Practice 3274780440 Practice locations: Austin, TX

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Howard University College of Medicine, 1984
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2013 Wells Branch Pkwy
Austin, TX 78728-6904
Phone (512) 251-2828

Hospital & facility affiliations

  • Robinson Creek Home Health and Hospice Home health agency, Austin, TX, CCN 677433
  • North Austin Medical Center Hospital, Austin, TX, CCN 450809

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Airrosti Rehab Centers, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: paul.bristol.1@16444.direct.athenahealth.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1780760595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 W PARMER LN STE A250",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787274115",
            "telephone_number": "512-799-1345",
            "fax_number": "844-445-6850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 W PARMER LN STE A250",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787274115",
            "telephone_number": "512-799-1345",
            "fax_number": "844-445-6850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISTOL",
        "first_name": "PAUL",
        "middle_name": "ELLIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G9265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.