Individual provider Active NPI

Travis Berry, PA

  • Physician Assistant
  • Abilene, TX
National Provider Identifier
1861107476
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16483 Issued in TX
Practice address
1904 Pine St Ste 3a
Abilene, TX 79601-2450
Phone
(325) 670-6180
Fax
(833) 437-1278
NPI assigned
Jan 18, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA16483 TX Primary

Addresses

Primary practice location

1904 Pine St Ste 3a
Abilene, TX 79601-2450

Mailing address

1904 Pine St Ste 3a
Abilene, TX 79601-2450
Phone (325) 670-6180

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230215003187 TX Practitioner - Physician Assistant 6406228642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hendrick Provider NetworkGroup PAC ID 9739162181, 234 clinicians

Practice addresses (Care Compare)

1900 Pine St
Abilene, TX 79601-2432

1904 Pine St
Abilene, TX 79601-2450

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hendrick Provider Network CurrentSince Feb 1, 2023 Accepting new patients

Locations

1904 Pine St
Ste 4A
Abilene, TX 79601
Phone (325) 437-4020

1904 Pine St
Ste 3A
Abilene, TX 79601
Phone (325) 670-6180

Interoperability endpoints

  • Direct secure messaging: travis.berry.1@21794.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1674000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1861107476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 PINE ST STE 3A",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796012450",
            "telephone_number": "325-670-6180",
            "fax_number": "833-437-1278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 PINE ST STE 3A",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796012450",
            "telephone_number": "325-670-6180",
            "fax_number": "833-437-1278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERRY",
        "first_name": "TRAVIS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-18",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA16483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.