Individual provider Active NPI

Jared Robert Sisson, PA

  • Surgical Physician Assistant
  • Austin, TX
National Provider Identifier
1356040042
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA18209 Issued in TX
Practice address
911 W 38TH St Ste 300
Austin, TX 78705-1161
Phone
(512) 439-1000
NPI assigned
Mar 1, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 029543 NY
Surgical Physician Assistant 363AS0400X PA18209 TX Primary
Medical Physician Assistant 363AM0700X PA18209 TX

Addresses

Primary practice location

911 W 38TH St Ste 300
Austin, TX 78705-1161

Mailing address

507 Virginia Dr
Round Rock, TX 78664-3048
Phone (512) 915-0538

Other practice location 1

4700 Campus Village Dr Ste 100
Round Rock, TX 78665-3025
Phone (512) 439-1000

Other practice location 2

4700 Seton Center Pkwy Ste 200
Austin, TX 78759-4107
Phone (212) 879-4700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231028000062 NY Practitioner - Physician Assistant 6103272067 Reassigns benefits to 1 organization
I20241219003801 TX Practitioner - Physician Assistant 6103272067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ortholonestar PLLCGroup PAC ID 9931529062, 416 clinicians

Practice addresses (Care Compare)

3755 S Capital of Texas Hwy
Suite 130
Austin, TX 78704-6623
Phone (512) 439-1000

3800 Gaylord Pkwy
Suite 710
Frisco, TX 75034-9635
Phone (214) 220-2468

4700 Campus Village Dr
Suite 100
Round Rock, TX 78665-3025
Phone (512) 439-1000

4700 Seton Ctr Pkwy
Austin, TX 78759-4107
Phone (512) 439-1000

911 W 38TH St
Suite 300
Austin, TX 78705-1161
Phone (512) 439-1000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ortholonestar, PLLC CurrentSince Dec 17, 2024 Accepting new patients
Ortholonestar, PLLC CurrentSince Dec 17, 2024 Accepting new patients
Wyckoff Professional Medical Services, PC CurrentSince Sep 6, 2023 Accepting new patients

Locations

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

911 W 38th St
Ste 300
Austin, TX 78705
Phone (512) 439-1002

4700 Seton Center Pkwy
Ste 200
Austin, TX 78759
Phone (512) 439-1011

3755 S Capital of Texas Hwy
Ste 130
Austin, TX 78704
Phone (512) 439-1005

4700 Seton Center Pkwy
Ste 115
Austin, TX 78759
Phone (346) 440-0644

3800 Gaylord Pkwy
Ste 710
Frisco, TX 75034

4700 Campus Village Dr
Ste 100
Round Rock, TX 78665
Phone (512) 439-1004

Interoperability endpoints

  • Direct secure messaging: jared.sisson.1@15533.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1677628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1356040042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 VIRGINIA DR",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786643048",
            "telephone_number": "512-915-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 W 38TH ST STE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051161",
            "telephone_number": "512-439-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Campus Village Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Round Rock",
            "state": "TX",
            "postal_code": "786653025",
            "country_code": "US",
            "telephone_number": "512-439-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4700 Seton Center Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787594107",
            "country_code": "US",
            "telephone_number": "212-879-4700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SISSON",
        "first_name": "JARED",
        "middle_name": "ROBERT",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-01",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "029543",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA18209",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA18209",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.