NPIMap

Individual provider Active NPI

Julia Nicole Fetters, PA-C

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1225677149
Registry record updated Dec 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA13442 Issued in TX
Practice address
10625 W Parmer LN Ste D400
Austin, TX 78717-4016
Phone
(512) 733-9400
NPI assigned
Dec 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TX
Physician Assistant 363A00000X PA13442 TX Primary

Addresses

Primary practice location

10625 W Parmer LN Ste D400
Austin, TX 78717-4016

Mailing address

10625 W Parmer LN Ste D400
Austin, TX 78717-4016
Phone (512) 733-9400

Other identifiers 1

IdentifierTypeStateIssuer
PA13442OtherTXTEXAS MEDICAL BOARD

Other names 1

  • Julia Nicole Bacak Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210818004279 TX Practitioner - Physician Assistant 9436554177 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carbon Health Medical Group of Florida PAGroup PAC ID 3274947304, 55 clinicians

Practice addresses (Care Compare)

17903 W Lake Houston Pkwy
Suite 101
Atascocita, TX 77346-3954
Phone (215) 570-6856

9722 Great Hills TRL
Suite 375
Austin, TX 78759-7263
Phone (512) 910-3932

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA13442TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carbon Health Medical Group of Florida PA CurrentSince Jun 28, 2025 Accepting new patients
Carbon Health Medical Group of Florida PA CurrentSince Jun 28, 2025 Accepting new patients

Locations

9722 Great Hills Trl
Ste 375
Austin, TX 78759
Phone (512) 240-9498

17903 W Lake Houston Pkwy
Ste 101
Humble, TX 77346
Phone (215) 570-6856

19220 S Ih 35
Ste 300
Kyle, TX 78640
Phone (737) 265-3964

3300 Bee Caves Rd
Ste 440
West Lake Hills, TX 78746
Phone (512) 399-0402

Organizations & group practices 12

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": "1577059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733529600000",
    "number": "1225677149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10625 W PARMER LN STE D400",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787174016",
            "telephone_number": "512-733-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10625 W PARMER LN STE D400",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787174016",
            "telephone_number": "512-733-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETTERS",
        "first_name": "JULIA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-23",
        "last_updated": "2024-12-07",
        "certification_date": "2024-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA13442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD",
            "identifier": "PA13442",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIA",
            "last_name": "BACAK",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.