Individual provider Active NPI

Vincent Edward Provasek, MDPHD

  • Neurological Surgery Physician
  • Austin, TX
National Provider Identifier
1831987700
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
BP10093528 Issued in TX
Practice address
1601 Trinity St BLDG B
Austin, TX 78712-1765
Phone
(253) 682-9554
NPI assigned
Apr 29, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X BP10093528 TX Primary

Addresses

Primary practice location

1601 Trinity St BLDG B
Austin, TX 78712-1765

Mailing address

1501 Red River St FL 2
Austin, TX 78712-1845

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
I20250505003334 TX Order and Referring Only - NeurosurgeryPractitioner - Neurosurgery 9234656109

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
BP10093528TXMDNeurological Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1745884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1831987700",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 TRINITY ST BLDG B",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787121765",
            "telephone_number": "253-682-9554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVASEK",
        "first_name": "VINCENT",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MDPHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-29",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "BP10093528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.