Individual provider Active NPI

Anne Weatherly Mahan, MD

  • Pediatrics Physician
  • Austin, TX
National Provider Identifier
1790989366
Registry record updated Nov 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
N8684 Issued in TX
Practice address
5339 N Ih 35 Ste 100
Austin, TX 78723-2558
Phone
(512) 628-1898
NPI assigned
Jun 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X N8684 TX
Pediatrics Physician 208000000X N8684 TX Primary

Addresses

Primary practice location

5339 N Ih 35 Ste 100
Austin, TX 78723-2558

Mailing address

5339 N Ih 35 Ste 100
Austin, TX 78723-2558
Phone (512) 628-1898

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
I20110818000064 TX Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 9133398696 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Critical Care (Intensivists)
Education
University of Texas Medical School at Houston, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dell Childrens Medical GroupGroup PAC ID 8224092978, 117 clinicians

Practice addresses (Care Compare)

1301 Barbara Jordan Blvd
Austin, TX 78723-3078

7506 Pineleaf PL
Austin, TX 78757-1763
Phone (512) 628-1898

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N8684TXMDPediatric Critical Care Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Critical Care Associates Pediatric Critical Care Medicine CurrentSince Jul 1, 2011 Accepting new patients
Seton Oral & Maxillofacial Surgery CurrentSince Jul 1, 2011 Accepting new patients
Dell Children'S Medical Group CurrentSince Sep 1, 2018 Accepting new patients
Dell Children'S Medical Group Pediatrics CurrentSince Sep 1, 2018 Accepting new patients

Locations

7506 Pineleaf Pl
Austin, TX 78757
Phone (512) 324-3315

1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800

4900 Mueller Blvd
Austin, TX 78723
Phone (512) 324-0165

1000 Hesters Crossing Rd
Round Rock, TX 78681
Phone (512) 628-1800

Interoperability endpoints

  • Direct secure messaging: anne.mahan.1@8363.direct.athenahealth.com

Organizations & group practices 4

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": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1790989366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5339 N IH 35 STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787232558",
            "telephone_number": "512-628-1898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5339 N IH 35 STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787232558",
            "telephone_number": "512-628-1898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAN",
        "first_name": "ANNE",
        "middle_name": "WEATHERLY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "TX",
            "license": "N8684",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N8684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.