Individual provider Active NPI

Semyon Gambarin, MD

  • Surgery Physician
  • Austin, TX
National Provider Identifier
1871508937
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
L6388 Issued in TX
Practice address
6811 Austin Center Blvd # 300
Austin, TX 78731-3166
Phone
(512) 346-8888
Fax
(512) 344-0335
NPI assigned
Jul 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X L6388 TX Primary

Addresses

Primary practice location

6811 Austin Center Blvd # 300
Austin, TX 78731-3166

Mailing address

6210 E Highway 290
Austin, TX 78723-1144
Phone (512) 407-8686

Other identifiers 4

IdentifierTypeStateIssuer
P00004603MedicaidTX
158094604MedicaidTX
158094602MedicaidTX
158094601MedicaidTX

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
I20070928000460 TX Practitioner - General Surgery 2769577204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Austin Regional Clinic PAGroup PAC ID 3072507789, 398 clinicians

Practice addresses (Care Compare)

6835 Austin Ctr Blvd
Austin, TX 78731-3166
Phone (512) 346-6611

Hospital & facility affiliations

  • Ascension Seton Northwest Hospital, Austin, TX, CCN 450867
  • Northwest Hills Surgical Hospital Hospital, Austin, TX, CCN 450808
  • North Austin Medical Center Hospital, Austin, TX, CCN 450809

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy74
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)17
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux21
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Regional Clinic, PA Surgery CurrentSince Jul 15, 2003 Accepting new patients
Austin Regional Clinic, PA CurrentSince Jul 15, 2003 Accepting new patients
Seton Hospitalist Service Past Accepting new patients

Locations

4515 Seton Center Pkwy
Ste 215
Austin, TX 78759
Phone (512) 338-3802

6835 Austin Center Blvd
Austin, TX 78731
Phone (512) 231-5210

6210 E Highway 290
Austin, TX 78723

6811 Austin Center Blvd
Ste 300
Austin, TX 78731
Phone (512) 346-8888

151 Exchange Blvd
Ste 500
Hutto, TX 78634
Phone (512) 846-1244

Interoperability endpoints

  • Direct secure messaging: sgambarin9910@arcmd.direct-ci.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.

Hospital & facility affiliations 3

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": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1871508937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 E HIGHWAY 290",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787231144",
            "telephone_number": "512-407-8686",
            "fax_number": "512-421-4489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6811 AUSTIN CENTER BLVD # 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787313166",
            "telephone_number": "512-346-8888",
            "fax_number": "512-344-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBARIN",
        "first_name": "SEMYON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-29",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "L6388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P00004603",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158094604",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158094602",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158094601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.