Individual provider Active NPI

Daniel Tavares Coelho, M.D.

  • Pediatrics Physician
  • Austin, TX
National Provider Identifier
1881037448
Registry record updated Sep 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
S8971 Issued in TX
Practice address
11714 Wilson Parke Ave Ste 150
Austin, TX 78726-4061
Phone
(512) 346-6611
Fax
(512) 406-6267
NPI assigned
Apr 14, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 281387-1 NY
Pediatrics Physician 208000000X S8971 TX Primary

Addresses

Primary practice location

11714 Wilson Parke Ave Ste 150
Austin, TX 78726-4061

Mailing address

6210 E Hwy 290
Austin, TX 78723-1142
Phone (512) 483-9596

Other identifiers 2

IdentifierTypeStateIssuer
424947601MedicaidTX
424947602MedicaidTX

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
I20210525002588 TX Practitioner - Pediatric Medicine 1951700806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Boston University School of Medicine, 2013
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)

11714 Wilson Parke Ave
Suite 150
Austin, TX 78726-4061
Phone (737) 247-7200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
281387-1NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Regional Clinic, PA Pediatrics CurrentSince Jun 14, 2021 Accepting new patients
Austin Regional Clinic, PA CurrentSince Jun 14, 2021 Accepting new patients

Locations

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

6210 E Highway 290
Austin, TX 78723

11714 Wilson Parke Ave
Ste 150
Austin, TX 78726
Phone (512) 346-6611

622 W State Highway 71
Ste 102
Bastrop, TX 78602
Phone (512) 308-4311

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

940 Hesters Crossing Rd
Round Rock, TX 78681
Phone (512) 244-9024

Interoperability endpoints

  • Direct secure messaging: dcoelho25597@arcmd.direct-ci.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.

NPI Registry JSON

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

{
    "created_epoch": "1365897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631491200000",
    "number": "1881037448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 E HWY 290",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787231142",
            "telephone_number": "512-483-9596",
            "fax_number": "512-406-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11714 WILSON PARKE AVE STE 150",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787264061",
            "telephone_number": "512-346-6611",
            "fax_number": "512-406-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COELHO",
        "first_name": "DANIEL",
        "middle_name": "TAVARES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-14",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "281387-1",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "S8971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "424947601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "424947602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.