SOUTH AUSTIN FAMILY PRACTICE CLINIC, PLLC – Family Medicine Physician, NPI 1235130592
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for SOUTH AUSTIN FAMILY PRACTICE CLINIC, PLLC
5625, Eiger Road, Austin, Travis County, Texas, 78735, United States
SUITE 200
AUSTIN, TX 787358982
Phone: (512) 892-7076
Fax: (239) 599-2625
Type: Location
3101 Highway 71 E Ste 101
Bastrop, TX 786025159
Phone: (512) 304-0300
Fax: (855) 270-9668
Type: Location
101 Medical Parkway
220
Lakeway, TX 787385621
Phone: (512) 358-8180
Fax: (855) 270-9668
Type: Location
170 Benney Ln Ste 200
Dripping Springs, TX 786205559
Phone: (512) 892-7076
Type: Location
12600 Hill Country Blvd Bldg R-103
Austin, TX 787386891
Phone: (512) 892-7076
Type: Location
912 S Capital Of Texas Hwy Ste 100
West Lake Hills, TX 787465242
Phone: (512) 892-7076
Type: Location
2015 S Interstate 35 Ste 130
Austin, TX 787413810
Phone: (512) 996-1466
Fax: (855) 270-9668
Type: Location
2675 WINKLER AVE FL 2
FORT MYERS, FL 339019342
Phone: (877) 856-3774
Fax: (239) 599-2625
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-05-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-11-30 (190 days ago).
Enrollment records
1
Earliest due date
2025-11-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040520001500 | O | Clinic/Group Practice | TX | 2025-11-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 78735)
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