Active NPI
Lone Star Endoscopy of Austin, PLLC
- Ambulatory Surgical Clinic/Center
- Austin, TX
National Provider Identifier
1902402183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- LONE STAR ENDOSCOPY OF AUSTIN, PLLC
- Practice address
- 9312 Brodie LN
Austin, TX 78748-5176 - Phone
- (512) 963-1428
- NPI assigned
- Dec 11, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rahesh Mehta, MD
- Title
- Manager
- Phone
- (512) 963-1428
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
9312 Brodie LN
Austin, TX 78748-5176
Mailing address
9312 Brodie LN
Austin, TX 78748-5176
Phone (512) 963-1428
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210409000224 | TX | Part B Supplier - Ambulatory Surgical Center | 6608284724 | Practice locations: Austin, TX |
National Provider Directory
National Provider DirectoryLocations
9312 Brodie Ln
#101
Austin, TX 78748
9312 Brodie Ln
#100
Austin, TX 78748
Phone (512) 963-1428
9312 Brodie Ln
Ste 200
Austin, TX 78748
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JGCDDD
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gastroenterology Physician
- Austin, TX
- NPI 1255414157
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607644800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1607644800000",
"number": "1902402183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9312 BRODIE LN",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787485176",
"telephone_number": "512-963-1428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9312 BRODIE LN",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787485176",
"telephone_number": "512-963-1428"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LONE STAR ENDOSCOPY OF AUSTIN, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-12-11",
"last_updated": "2020-12-11",
"certification_date": "2020-12-11",
"status": "A",
"authorized_official_last_name": "MEHTA",
"authorized_official_first_name": "RAHESH",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "512-963-1428",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.