Organization Active NPI

Capital City Orthopaedics PA

  • Orthopaedic Surgery Physician
  • Austin, TX
National Provider Identifier
1932308228
Registry record updated May 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
L9638 Issued in TX
Legal business name
CAPITAL CITY ORTHOPAEDICS PA
Practice address
12201 Renfert Way Ste 370
Austin, TX 78758-5376
Phone
(512) 617-1989
Fax
(512) 617-2065
NPI assigned
Jul 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2016

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

Authorized official

Name
Mike Burris, MD
Title
President
Phone
(512) 617-1989

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X L9638 TX Primary

Addresses

Primary practice location

12201 Renfert Way Ste 370
Austin, TX 78758-5376

Mailing address

12201 Renfert Way Ste 370
Austin, TX 78758-5376
Phone (512) 617-1989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080212000491 TX Part B Supplier - Clinic/Group Practice 1759464894 Receives reassigned benefits from 2 practitioners
Practice locations: Austin, TX
O20120315000179 TX DME Supplier - Physician - Orthopedic/Orthopedic Surgery 1759464894 Practice locations: Austin, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462492800000",
    "number": "1932308228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 RENFERT WAY STE 370",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585376",
            "telephone_number": "512-617-1989",
            "fax_number": "512-617-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12201 RENFERT WAY STE 370",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585376",
            "telephone_number": "512-617-1989",
            "fax_number": "512-617-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL CITY ORTHOPAEDICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-16",
        "last_updated": "2016-05-06",
        "status": "A",
        "authorized_official_last_name": "BURRIS",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-617-1989",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "L9638",
            "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 May 6, 2016; 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.

Verify at the official NPI Registry.