Individual provider Active NPI

Andrew Martin Pratt, PHYSICIAN ASSISTANT

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1265860159
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4045 Broadway
San Antonio, TX 78209-6313
Phone
(210) 826-1830
NPI assigned
Oct 31, 2013
Last updated
Jan 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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 NU Primary

Addresses

Primary practice location

4045 Broadway
San Antonio, TX 78209-6313

Mailing address

800 County Road 117
Round Rock, TX 78665-7484
Phone (210) 488-5327

Other practice location 1

1106 Clayton Ln Ste 240W
Austin, TX 78723-2478
Phone (737) 471-5402

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
I20150504002106 TX Practitioner - Physician Assistant 0042539686 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southwest Neuropsychiatry Association PLLCGroup PAC ID 8022415041, 3 clinicians
Senior Psychcare of San Antonio I PLLCGroup PAC ID 8628241544, 13 clinicians

Practice addresses (Care Compare)

1106 Clayton LN
Suite 240W
Austin, TX 78723-2478
Phone (737) 471-5402

4635 Southwest Fwy
Suite 635
Houston, TX 77027-7112
Phone 71385000491053

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1383177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1265860159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 COUNTY ROAD 117",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786657484",
            "telephone_number": "210-488-5327",
            "fax_number": "210-404-9466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 BROADWAY",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782096313",
            "telephone_number": "210-826-1830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1106 Clayton Ln Ste 240W",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787232478",
            "country_code": "US",
            "telephone_number": "737-471-5402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRATT",
        "first_name": "ANDREW",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-31",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.