Individual provider Active NPI

James Fallon Jeffrey, PA-C

  • Physician Assistant
  • Cedar Park, TX
National Provider Identifier
1013074004
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18014 Issued in TX
Practice address
910 E Whitestone Blvd
Cedar Park, TX 78613-9093
Phone
(512) 260-6100
Fax
(512) 260-6129
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-9101291 FL
Physician Assistant 363A00000X PA-54805 CA
Medical Physician Assistant 363AM0700X PA- 9101291 FL
Physician Assistant 363A00000X PA18014 TX Primary

Addresses

Primary practice location

910 E Whitestone Blvd
Cedar Park, TX 78613-9093

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111

Other practice location 1

25461 Rancho Niguel Rd
Laguna Niguel, CA 92677-7304
Phone (949) 535-1199

Other identifiers 1

IdentifierTypeStateIssuer
PA-9101291OtherFLPA LICENSE #

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jjeffrey1350911@direct.sw.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180223002189 CA Practitioner - Physician Assistant 4587836978 Reassigns benefits to 2 organizations
I20240805003493 TX Practitioner - Physician Assistant 4587836978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Florida College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

1507 Rivery Blvd
Georgetown, TX 78628-3058
Phone (512) 509-9550

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

4945 Williams Dr
Baylor Scott and White Clinic Georg
Georgetown, TX 78633-2008
Phone (512) 819-0500

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

900 E Whitestone Blvd
Cedar Park, TX 78613-9093
Phone (512) 684-4911

910 E Whitestone Blvd
Baylor Scott and White Clinic Cedar
Cedar Park, TX 78613-9093
Phone (512) 260-6100

Hospital & facility affiliations

  • Baylor Scott & White Medical Center - Round Rock Hospital, Round Rock, TX, CCN 670034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-54805CAMDPhysician Assistant
PA-9101291FLMDPhysician Assistant
PA18014TXMDPhysician Assistant
PA- 9101291FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic CurrentSince Jul 30, 2024 Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

2608 Brockton Dr
Austin, TX 78758
Phone (512) 654-4050

1701 E Pflugerville Pkwy
Pflugerville, TX 78660
Phone (512) 259-6000

2401 S 31st St
#200
Temple, TX 76508
Phone (254) 215-0100

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

Interoperability endpoints

  • Direct secure messaging: jjeffrey1350911@direct.sw.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1013074004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 E WHITESTONE BLVD",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786139093",
            "telephone_number": "512-260-6100",
            "fax_number": "512-260-6129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25461 Rancho Niguel Rd",
            "address_purpose": "LOCATION",
            "city": "Laguna Niguel",
            "state": "CA",
            "postal_code": "926777304",
            "country_code": "US",
            "telephone_number": "949-535-1199",
            "fax_number": "949-535-1109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEFFREY",
        "first_name": "JAMES",
        "middle_name": "FALLON",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA-9101291",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA-54805",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA- 9101291",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE #",
            "identifier": "PA-9101291",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjeffrey1350911@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "910 E Whitestone Blvd",
            "city": "Cedar Park",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786139093",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

Verify at the official NPI Registry.