Active NPI
Simin Berenji, PA
- Physician Assistant
- Georgetown, TX
National Provider Identifier
1871154591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA13300
- Practice address
- 4945 Williams Dr
Georgetown, TX 78633-2008 - Phone
- (512) 259-6000
- Fax
- (210) 706-2582
- NPI assigned
- Jun 24, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA13300 | TX | Primary |
Addresses
Primary practice location
4945 Williams Dr
Georgetown, TX 78633-2008
Mailing address
PO Box 844658
Dallas, TX 75284-4658
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | sberenji1211431@direct.sw.org |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210615001065 | TX | Practitioner - Physician Assistant | 1254731144 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Scott and White Clinic
Practice addresses (Care Compare)
1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100
2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459
2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663
4945 Williams Dr
Baylor Scott and White Clinic Georg
Georgetown, TX 78633-2008
Phone (512) 819-0500
810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585
Hospital & facility affiliations
- Baylor Scott & White Medical Center - Round Rock
- Baylor Scott & White Medical Center - Temple
- Baylor Scott & White Medical Center Pflugerville
- Baylor Scott & White Institute for Rehabilitation
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA13300 | TX | MD | Physician Assistant |
Organizations & group practices 4
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.
-
- Eyewear Supplier
- Temple, TX
- NPI 1457314528
-
- Clinical Medical Laboratory
- Brenham, TX
- NPI 1710468012
-
- Rural Health Clinic/Center
- Brenham, TX
- NPI 1902384951
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Pflugerville, TX
- NPI 1346729159
Hospital
-
- General Acute Care Hospital
- Round Rock, TX
- NPI 1265568638
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698278400000",
"number": "1871154591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 844658",
"city": "DALLAS",
"state": "TX",
"postal_code": "752844658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4945 WILLIAMS DR",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786332008",
"telephone_number": "512-259-6000",
"fax_number": "210-706-2582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERENJI",
"first_name": "SIMIN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-24",
"last_updated": "2023-10-26",
"certification_date": "2023-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA13300",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sberenji1211431@direct.sw.org",
"affiliation": "N",
"address_1": "4945 Williams Dr",
"city": "Georgetown",
"state": "TX",
"country_code": "US",
"postal_code": "786332008",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Georgetown, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.