AUSTIN FERTILITY INSTITUTE, PA (NPI# 1083934830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083934830 |
| Entity Type | Organization |
| Organization Name | AUSTIN FERTILITY INSTITUTE, PA |
| Practice Address |
2200 Park Bend Dr Bldg. 2 - Suite 204 Austin TX 78758-5387 |
| Practice Telephone | 5123394234 |
| Practice Fax Number | 5123394237 |
| Mailing Telephone | 5123394234 |
| Mailing Fax Number | 5123394237 |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2010-06-03 |
| Authorized Official Name | DR. KENNETH KAMYAR MOGHADAM (DIRECTOR/PHYSICIAN) |
| Authorized Official Telephone | 5123394234 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VE0102X |
Obstetrics & Gynecology Specialization: Reproductive Endocrinology |
N5874 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
2200 PARK BEND DR BLDG. 2 - SUITE 204 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78758-5387 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134115595 | Richard B Stovall | Neurological Surgery | 2200 Park Bend Dr, Bldg 2, Ste 201, Austin, TX 78758-5388 | 2005-09-21 |
| 1811410392 | Brenda Cobian Olmos | Nurse Practitioner | 2200 Park Bend Dr, Austin, TX 78758-5387 | 2017-07-17 |
| 1538610274 | Rockdale Blackhawk, LLC | General Practice | 2200 Park Bend Dr, Bldg 2-301, Austin, TX 78758-5387 | 2016-10-18 |
| 1538612981 | Lily Swann | Physical Therapist | 2200 Park Bend Dr, Austin, TX 78758-5387 | 2016-08-02 |
| 1669826376 | Antionne Harp | Chiropractor | 2200 Park Bend Dr, Suite 300, Austin, TX 78758-5387 | 2016-04-19 |
| 1699154716 | Cs Surgical Pllc | Physician Assistant | 2200 Park Bend Dr, Ste 2-201, Austin, TX 78758-5387 | 2015-05-21 |
| 1699169276 | Tessa Gibbs | Nurse Practitioner | 2200 Park Bend Dr, Building 1 Suite 201, Austin, TX 78758-5388 | 2015-03-23 |
| 1063815769 | Neva M. Schmelzer | Nurse Practitioner | 2200 Park Bend Dr, Bldg 1, Suite 401, Austin, TX 78758-5387 | 2014-10-08 |
| 1851790083 | Matthew Gieringer | Physical Therapist | 2200 Park Bend Dr, Building 1 Suite 202, Austin, TX 78758-5387 | 2014-08-13 |
| 1629484852 | Sara Jean Linedecker | Pharmacist | 2200 Park Bend Dr, Bldg 1, Ste 300, Austin, TX 78758-5387 | 2014-07-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225644065 | Seton Family of Doctors | Internal Medicine | 3001 Palm Way, D1 : 134-138, Austin, TX 78758 | 2020-09-17 |
| 1083243661 | Donna Bella Laurel Portillo | Pharmacist | 12221 N Mopac Expwy, Austin, TX 78758 | 2020-04-05 |
| 1881249092 | Elizabeth Logan Anderson | Behavioral Analyst | 2100 Kramer Ln., Suite 150, Austin, TX 78758 | 2019-08-05 |
| 1295388502 | Bridget Sue Morgan | Behavioral Analyst | 2100 Kramer Ln #150, Austin, TX 78758 | 2019-07-17 |
| 1508326885 | Jonathan James Runnels | Anesthesiologist Assistant | 12221n Mopac, Austin, TX 78758 | 2019-03-22 |
| 1427527324 | Nayely Gutierrez | Dietitian, Registered | 8606 Delaware Ct, Austin, TX 78758 | 2018-11-20 |
| 1720569635 | Shari Wright | Licensed Vocational Nurse | 12349 Metric Blvs # 425, Austin, TX 78758 | 2018-08-28 |
| 1528545456 | Alexis N Bongiorno | Registered Nurse | 11901 Hobby Horse Court, 1516, Austin, TX 78758 | 2018-07-24 |
| 1679072573 | Lori Scott | Counselor | 1600 Payton Gin Road, Austin, TX 78758 | 2018-02-06 |
| 1003322488 | Lisa Robyn Lee | Behavior Technician | 2018 W Rundberg Ln, #13d, Austin, TX 78758 | 2017-12-20 |
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| Taxonomy Code | 207VE0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Reproductive Endocrinology |
| An obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170791 | Theresa Manriquez | Obstetrics & Gynecology | 300 Beardsley Ln Ste 200, Austin, TX 78746-4945 | 2020-10-01 |
| 1134741556 | Fora Fertility, Pllc | Obstetrics & Gynecology | 2200 Pecos St, Austin, TX 78703-2124 | 2020-05-07 |
| 1659575223 | Summer Leigh James | Obstetrics & Gynecology | 6500 N Mopac Expy Bldg I, Suite 1200, Austin, TX 78731-3282 | 2007-06-14 |
| 1710085089 | Austin Endometriosis & Female Infertility Center Pa | Obstetrics & Gynecology | 4303 James Casey St, Suite A, Austin, TX 78145-1188 | 2006-09-20 |
| 1033185855 | Kaylen Mark Silverberg | Obstetrics & Gynecology | 6500 North Mopac, Bldg I, Suite 1200, Austin, TX 78731 | 2006-02-23 |
| 1336114305 | Anthony Mark Propst | Obstetrics & Gynecology | 6500 N Mopac Expressway Bldg 1 Suite 1200, Austin, TX 78731-7873 | 2006-02-22 |
| 1295349041 | Aspire Fertility Institute, Inc. | Obstetrics & Gynecology | 911 W 38th St Ste 402, Austin, TX 78705-1122 | 2020-08-31 |
| 1689954745 | Westlake Ivf | Obstetrics & Gynecology | 300 Beardsley Ln, Bldg B, Ste 200, Austin, TX 78746-4945 | 2011-08-22 |
| 1659687275 | Amanda Skillern | Obstetrics & Gynecology | 715 W 34th St, Austin, TX 78705-1223 | 2010-08-19 |
| 1114186533 | Natalie Minns Crawford | Obstetrics & Gynecology | 715 W 34th St, Austin, TX 78705-1223 | 2008-06-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.