Janice Yates, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA19745 Issued in TX

Practice address

5 Coughran Rd Ste 101
Boerne, TX 78006-8103

Phone

(830) 491-4040

NPI assigned

Nov 26, 2007

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Ms. Janice Yates Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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

• Blue Agave Functional Medicine Bulverde PLLC

  dba Blue Agave Functional Medicine Clinic

  • General Practice Physician
  • Spring Branch, TX
  • NPI 1215888573
  NPD
• Blue Agave Functional Medicine Boerne PLLC

  dba Blue Agave Functional Medicine Clinic

  • General Practice Physician
  • Boerne, TX
  • NPI 1235096447
  NPD (past)

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1164603791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 COUGHRAN RD STE 101",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780068103",
            "telephone_number": "830-491-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 COUGHRAN RD STE 101",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780068103",
            "telephone_number": "830-491-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YATES",
        "first_name": "JANICE",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-26",
        "last_updated": "2026-07-13",
        "certification_date": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA19745",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA052004",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60056456",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANICE",
            "last_name": "YATES",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katie Wyse, PT
• Yang Xia, MD
• Yalad, LLC (Birth Experience Midwifery Care)
• Yang Xia MD PLLC
• Earl Grady Yarbrough Jr., LPC
• Chloe Danielle Young
• Laura Anne Young
• Your Neighborhood Family Practice PLLC
• Richard V Zapf, MS, LMFT
• Alykhym Buentipo Zarzuela, D.O.

• Physician Assistant in Boerne, TX
• Providers in Boerne, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.