Wayne Benedict Stanberry, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01479 Issued in TX

Practice address

1000 E 41St St Ste 925
Austin, TX 78751-4856

Phone

(512) 978-9940

Fax

(512) 901-9702

NPI assigned

Feb 6, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

May accept Medicare assignment

Group practices

Central Texas Community Health CentersGroup PAC ID 5395802151, 165 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Central Texas Community Health Centers

  • Family Medicine Physician
  • Austin, TX
  • NPI 1427882091
  Medicare reassignment Care Compare group NPD
• Central Texas Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Austin, TX
  • NPI 1598591414
  NPD
• Bcep PA

  • Emergency Medical Services (Emergency Medicine) Physician
  • Austin, TX
  • NPI 1629291844
  NPD (past)
• Central Texas Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Austin, TX
  • NPI 1861420382
  NPD (past)
• Denton Erdocs PA

  • Nurse Practitioner
  • Denton, TX
  • NPI 1295780906

  Physician Assistant

  NPD (past)
• Third Coast Emergency Physicians Sid Peterson PA

  • Emergency Medicine Physician
  • Kerrville, TX
  • NPI 1972541423
  NPD (past)
• Moore Primary Care Inc

  • Family Medicine Physician
  • Moore, OK
  • NPI 1063536233
  NPD (past)
• R E F M Emergency Services

  • Emergency Care Clinic/Center
  • Hugo, OK
  • NPI 1194716530
  NPD (past)

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542153600000",
    "number": "1861670341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E 41ST ST STE 925",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787514856",
            "telephone_number": "512-978-9940",
            "fax_number": "512-901-9702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 41ST ST STE 925",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787514856",
            "telephone_number": "512-978-9940",
            "fax_number": "512-901-9702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANBERRY",
        "first_name": "WAYNE",
        "middle_name": "BENEDICT",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-06",
        "last_updated": "2018-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA01479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8Y3725",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8Y3735",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Stallworth, PH.D.
• Susan Stallworth, LPC
• Suzanne Lisa Stambaugh, PSYD
• Alanis Stamey
• Julia Stamman, MS, LPC
• Sarah Marie Stancey, M.S., CCC-SLP
• Karisa Rae Stancil, FNP-C
• Chelsea E Stanciu, CRNA
• Thomas J Stanciu, MD
• Elizabeth Standish, OT

• Physician Assistant in Austin, TX
• Providers in Austin, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.