Individual provider Active NPI

Pauline Otieno

  • Family Nurse Practitioner
  • Austin, TX
National Provider Identifier
1790130292
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP130845 Issued in TX
Practice address
3901A Spicewood Springs Rd
Suite 202
Austin, TX 78759-8723
Phone
(737) 226-6700
Fax
(737) 226-6777
NPI assigned
May 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP130845 TX Primary

Addresses

Primary practice location

3901A Spicewood Springs Rd
Suite 202
Austin, TX 78759-8723

Mailing address

17855 Park Valley Dr
Round Rock, TX 78681-3509
Phone (512) 507-8075

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160705000988 TX Practitioner - Nurse Practitioner 0547552911 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Curana Health Medical Group LLC CurrentSince May 16, 2016 Accepting new patients

Locations

3901A Spicewood Springs Rd
Ste 201
Austin, TX 78759
Phone (737) 226-6713

3901A Spicewood Springs Rd
Ste 202
Austin, TX 78759

901 Discovery Blvd
Cedar Park, TX 78613
Phone (512) 259-9993

2000 Scenic Dr
Georgetown, TX 78626
Phone (512) 863-2117

401 Oakwood Blvd
Round Rock, TX 78681
Phone (512) 388-7494

9903 Hunters Pond
San Antonio, TX 78224
Phone (210) 477-2200

Interoperability endpoints

  • 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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1790130292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17855 PARK VALLEY DR",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786813509",
            "telephone_number": "512-507-8075",
            "fax_number": "512-246-0995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901A SPICEWOOD SPRINGS RD",
            "address_2": "SUITE 202",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598723",
            "telephone_number": "737-226-6700",
            "fax_number": "737-226-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTIENO",
        "first_name": "PAULINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-03",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP130845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.