Individual provider Active NPI

Maria Suzanne Bosley Bloomquist, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Austin, TX
National Provider Identifier
1841797446
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
U0966 Issued in TX
Practice address
8825 Bee Caves Rd Ste 100
Austin, TX 78746-4721
Phone
(512) 328-3376
Fax
(512) 666-3767
NPI assigned
Apr 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X U0966 TX Primary
Dermatopathology (Pathology) Physician 207ZD0900X U0966 TX

Addresses

Primary practice location

8825 Bee Caves Rd Ste 100
Austin, TX 78746-4721

Mailing address

8825 Bee Caves Rd Ste 100
Austin, TX 78746-4721
Phone (512) 328-3376

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
I20230405002649 TX Practitioner - Pathology 5395110357 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Baylor College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westlake Dermatology PAGroup PAC ID 6305817230, 52 clinicians

Practice addresses (Care Compare)

8825 Bee Caves Rd
Suite 100
Austin, TX 78746-4721
Phone (512) 328-3376

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
U0966TXMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Westlake Dermatology PA Current Accepting new patients
Westlake Dermatology PA CurrentSince Apr 15, 2023 Accepting new patients
Westlake Dermatology, PA CurrentSince Apr 15, 2023 Accepting new patients

Locations

12201 Renfert Way
Ste 305
Austin, TX 78758
Phone (513) 279-3376

8825 FM 2244 Rd
Ste 100
Austin, TX 78746

401 S FM 620 Rd
Ste 200
Lakeway, TX 78734
Phone (512) 610-0549

1760 Round Rock Ave
Round Rock, TX 78681
Phone (512) 583-3376

Organizations & group practices 3

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": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1841797446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8825 BEE CAVES RD STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787464721",
            "telephone_number": "512-328-3376",
            "fax_number": "512-666-3767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8825 BEE CAVES RD STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787464721",
            "telephone_number": "512-328-3376",
            "fax_number": "512-666-3767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOMQUIST",
        "first_name": "MARIA",
        "middle_name": "SUZANNE BOSLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "U0966",
            "primary": true
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "TX",
            "license": "U0966",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.