Individual provider Active NPI

Ashley Wynne Jacobsen, PA-C

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1366964751
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA11323 Issued in TX
Practice address
19272 Stone Oak Pkwy Ste 101
San Antonio, TX 78258-3372
Phone
(210) 265-8851
NPI assigned
Jul 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2026

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 PA11323 TX Primary

Addresses

Primary practice location

19272 Stone Oak Pkwy Ste 101
San Antonio, TX 78258-3372

Mailing address

19272 Stone Oak Pkwy Ste 101
San Antonio, TX 78258-3372

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
I20171010001026 TX Practitioner - Physician Assistant 8325313828 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NSC Consultants, PAGroup PAC ID 5991850414, 9 clinicians

Practice addresses (Care Compare)

4611 Centerview
San Antonio, TX 78228-1202
Phone (210) 255-8935

Hospital & facility affiliations

  • South Texas Spine and Surgical Hospital Hospital, San Antonio, TX, CCN 450856

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA11323TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
M. Reza Mizani, M.D., P.a. Past Accepting new patients

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 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": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1366964751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19272 STONE OAK PKWY STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19272 STONE OAK PKWY STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583372",
            "telephone_number": "210-265-8851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "ASHLEY",
        "middle_name": "WYNNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA11323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.