Individual provider Active NPI

Crystal Freeman, PA-C

  • Surgical Physician Assistant
  • Austin, TX
National Provider Identifier
1871860528
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA07547 Issued in TX
Practice address
1301 Barbara Jordan Blvd
Ste 300
Austin, TX 78723-3077
Phone
(512) 478-8116
Fax
(512) 478-9368
NPI assigned
Nov 23, 2011
Last updated
Feb 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA07547 TX Primary

Addresses

Primary practice location

1301 Barbara Jordan Blvd
Ste 300
Austin, TX 78723-3077

Mailing address

1301 Barbara Jordan Blvd
Ste 300
Austin, TX 78723-3077
Phone (512) 478-8116

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
I20120126000665 TX Practitioner - Physician Assistant 9436326758 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA07547TXMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Surgeons Who Only Care for Kids, PA CurrentSince Jan 17, 2023 Accepting new patients

Locations

1301 Barbara Jordan Blvd
Ste 400
Austin, TX 78723
Phone (512) 708-4567

1401 Medical Pkwy
Cedar Park, TX 78613
Phone (512) 528-7000

Interoperability endpoints

  • Direct secure messaging: crystal.freeman.1@8363.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1322006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1871860528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD",
            "address_2": "STE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233077",
            "telephone_number": "512-478-8116",
            "fax_number": "512-478-9368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 BARBARA JORDAN BLVD",
            "address_2": "STE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233077",
            "telephone_number": "512-478-8116",
            "fax_number": "512-478-9368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "CRYSTAL",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-23",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA07547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.