Individual provider Active NPI

Marisa R Izaguirre, MD

  • Pediatric Gastroenterology Physician
  • Austin, TX
National Provider Identifier
1851684401
Registry record updated Aug 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
Q0076 Issued in TX
Practice address
1301 Barbara Jordan Blvd
Suite 200
Austin, TX 78723-3077
Phone
(512) 628-1810
NPI assigned
May 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X Q0076 TX Primary

Addresses

Primary practice location

1301 Barbara Jordan Blvd
Suite 200
Austin, TX 78723-3077

Mailing address

1301 Barbara Jordan Blvd
Suite 200
Austin, TX 78723-3077
Phone (512) 628-1810

Other names 1

  • Marisa Rodriguez Former name

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
I20140801000164 TX Practitioner - Pediatric MedicinePractitioner - Gastroenterology 0547486276 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dell Children'S Medical Group CurrentSince Jul 1, 2014 Accepting new patients
Dell Children'S Medical Group Pediatric Gastroenterology Current Accepting new patients
Dell Children'S Medical Group Pediatric Gastroenterology CurrentSince Jul 1, 2014 Accepting new patients

Locations

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

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

Interoperability endpoints

  • Direct secure messaging: marisa.izaguirre.1@8363.direct.athenahealth.com

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": "1305504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408579200000",
    "number": "1851684401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD",
            "address_2": "SUITE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233077",
            "telephone_number": "512-628-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD",
            "address_2": "SUITE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233077",
            "telephone_number": "512-628-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZAGUIRRE",
        "first_name": "MARISA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-16",
        "last_updated": "2014-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "TX",
            "license": "Q0076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISA",
            "last_name": "RODRIGUEZ",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.