Spicewood Dermatology, P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

License

L4986 Issued in TX

Legal business name

SPICEWOOD DERMATOLOGY, P.A.

Practice address

13642 N. Hwy 183
BLDG 2 Ste 100
Austin, TX 78750

Phone

(512) 331-7300

Fax

(512) 331-7318

NPI assigned

Jan 26, 2007

Organization subpart

No

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

Authorized official

Name

David Feng Jeng

Title

Practice Manager

Phone

(512) 331-7300

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AFBGAA

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Noet Ellesse Avila

  • Physician Assistant
  • Austin, TX
  • NPI 1023875796
  Medicare reassignment Care Compare group NPD
• Dana Chang Jeng, M.D.

  • Specialist
  • Austin, TX
  • NPI 1396728309
  Medicare reassignment Care Compare group NPD
• Yoon Sin Kim, D.O.

  • Family Medicine Physician
  • Temple, TX
  • NPI 1235150764
  Medicare reassignment Care Compare group NPD
• Sarah Coatney

  • Physician Assistant
  • Tulsa, OK
  • NPI 1922775568

  TX

  Medicare reassignment Care Compare group NPD
• Kristen Marie Neumann, PA-C

  • Physician Assistant
  • Cedar Park, TX
  • NPI 1609245968
  Medicare reassignment
• Abigail Shearer

  • Physician Assistant
  • Austin, TX
  • NPI 1396487930
  Medicare reassignment

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366070400000",
    "number": "1841346285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13642 N. HWY 183",
            "address_2": "BLDG 2 STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78750",
            "telephone_number": "512-331-7300",
            "fax_number": "512-331-7318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13642 N. HWY 183",
            "address_2": "BLDG 2 STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78750",
            "telephone_number": "512-331-7300",
            "fax_number": "512-331-7318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPICEWOOD DERMATOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2013-04-16",
        "status": "A",
        "authorized_official_last_name": "JENG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "FENG",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "512-331-7300"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "L4986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ann Speyrer
• Asa R Sphar III, PH.D., LPC, LMFT
• Delaney Catherine Spicer, OTR/L
• Serie Spicer, PHD
• Spicewood Anesthesia Associates
• Spicewood Outpatient LLC
• Spicewood Springs Dental Center
• Spicewood Surgery Center LLC
• Brooke Spickler, M.S., CCC-SLP
• Justin Spiegelman, DMD

• Specialist in Austin, TX
• Providers in Austin, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.