Individual provider Active NPI

Jason D Hinojosa, PA-C

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1205183670
Registry record updated Oct 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA07940 Issued in TX
Practice address
111 Dallas St
San Antonio, TX 78205-1201
Phone
(210) 495-9860
NPI assigned
Aug 5, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2016

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 PA07940 TX Primary

Addresses

Primary practice location

111 Dallas St
San Antonio, TX 78205-1201

Mailing address

16414 San Pedro Ave
Suite 525
San Antonio, TX 78232-2277
Phone (210) 495-9860

Other identifiers 2

IdentifierTypeStateIssuer
304079202 (CSHCN)MedicaidTX
304079201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA07940TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
River City Emergency Physicians, PLLC Past Accepting new patients

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": "1344124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1205183670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16414 SAN PEDRO AVE",
            "address_2": "SUITE 525",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782322277",
            "telephone_number": "210-495-9860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DALLAS ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782051201",
            "telephone_number": "210-495-9860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINOJOSA",
        "first_name": "JASON",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-05",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304079202 (CSHCN)",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304079201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.