Individual provider Active NPI

Jessie Alexandra Bangs, MD, L.AC.

  • Psychiatry Physician
  • Austin, TX
National Provider Identifier
1134540438
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
T4708 Issued in TX
Practice address
4900 Mueller Blvd
Austin, TX 78723-3051
Phone
(512) 324-0101
NPI assigned
Jan 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC01498 TX
Child & Adolescent Psychiatry Physician 2084P0804X T4708 TX
Student in an Organized Health Care Education/Training Program 390200000X BP10072954 TX
Psychiatry Physician 2084P0800X T4708 TX Primary

Addresses

Primary practice location

4900 Mueller Blvd
Austin, TX 78723-3051

Mailing address

4900 Mueller Blvd
Austin, TX 78723-3051

Other practice location 1

1501 Red River St Fl 2
Austin, TX 78712-1845
Phone (512) 495-5555

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230704000091 TX Practitioner - Psychiatry 3173982519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Texas Tech University Health Science Center School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

3223 S Loop
289 Suite 600
Lubbock, TX 79423-1372
Phone (833) 351-8255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
AC01498TXMDAcupuncturist
T4708TXMDChild & Adolescent Psychiatry Physician
BP10072954TXMDStudent in an Organized Health Care Education/Training Program

Interoperability endpoints

  • Direct secure messaging: jessie.bangs.1@8363.direct.athenahealth.com

Organizations & group practices 1

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": "1388793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1134540438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 MUELLER BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 MUELLER BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787233051",
            "telephone_number": "512-324-0101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Red River St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787121845",
            "country_code": "US",
            "telephone_number": "512-495-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANGS",
        "first_name": "JESSIE",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "MD, L.AC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-04",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "TX",
            "license": "AC01498",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "T4708",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10072954",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "T4708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.