Individual provider Active NPI

Emily Elisa Hodges, PA-C

  • Physician Assistant
  • Boerne, TX
National Provider Identifier
1023716693
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16478 Issued in TX
Practice address
120 Medical Dr
Boerne, TX 78006-1830
Phone
(830) 816-5700
NPI assigned
Feb 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA16478 TX Primary

Addresses

Primary practice location

120 Medical Dr
Boerne, TX 78006-1830

Mailing address

PO Box 555
Bandera, TX 78003
Phone (830) 931-3336

Other practice location 1

1051 Old Hwy US 90
Castroville, TX 78009
Phone (830) 931-3336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230320000848 TX Practitioner - Physician Assistant 7315311065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Texas Medical School at San Antonio, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medcare Associates PAGroup PAC ID 5294714580, 28 clinicians

Practice addresses (Care Compare)

1051 US Hwy 90 E
Castroville, TX 78009-5210
Phone (830) 931-3336

120 Medical Dr
Boerne, TX 78006-1830
Phone (830) 816-5700

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA16478TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medcare Associates PA Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1677024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1023716693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 555",
            "city": "BANDERA",
            "state": "TX",
            "postal_code": "78003",
            "telephone_number": "830-931-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MEDICAL DR",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780061830",
            "telephone_number": "830-816-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1051 Old Hwy US 90",
            "address_purpose": "LOCATION",
            "city": "Castroville",
            "state": "TX",
            "postal_code": "78009",
            "country_code": "US",
            "telephone_number": "830-931-3336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HODGES",
        "first_name": "EMILY",
        "middle_name": "ELISA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-22",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA16478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

Verify at the official NPI Registry.