Organization Active NPI

Matsubara and Associates PA

  • Family Medicine Physician
  • Round Rock, TX
National Provider Identifier
1982751061
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
K9122 Issued in TX
Legal business name
MATSUBARA AND ASSOCIATES PA
Doing business as
Sundance Family Health Center
Practice address
1000 Hesters Crossing Road
Suite 100
Round Rock, TX 78681
Phone
(512) 218-4900
Fax
(512) 218-4908
NPI assigned
Jan 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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

Authorized official

Name
Patrick Boyle
Title
Contract Coordinator
Phone
(512) 494-5911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X K9122 TX Primary

Addresses

Primary practice location

1000 Hesters Crossing Road
Suite 100
Round Rock, TX 78681

Mailing address

8409 Ironweed Road
Round Rock, TX 78681
Phone (512) 382-5339

Other names 1

  • Sundance Family Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070621000660 TX Part B Supplier - Clinic/Group Practice 6507965175 Receives reassigned benefits from 1 practitioner
Practice locations: Round Rock, TX

National Provider Directory

National Provider Directory

Locations

7700 Cat Hollow Dr
Ste 205
Round Rock, TX 78681
Phone (512) 218-4900

1000 Hesters Crossing Rd
Ste 100
Round Rock, TX 78681
Phone (512) 218-4900

Practitioners & affiliated clinicians

Practitioners 1

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": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193356800000",
    "number": "1982751061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8409 IRONWEED ROAD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "78681",
            "telephone_number": "512-382-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HESTERS CROSSING ROAD",
            "address_2": "SUITE 100",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "78681",
            "telephone_number": "512-218-4900",
            "fax_number": "512-218-4908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATSUBARA AND ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-10-26",
        "status": "A",
        "authorized_official_last_name": "BOYLE",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "CONTRACT COORDINATOR",
        "authorized_official_telephone_number": "512-494-5911"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K9122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sundance Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.