Jennifer L Tackett, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10000840A Issued in IN

Practice address

11675 Jollyville Rd Ste 207
Austin, TX 78759-4105

Phone

(512) 856-1000

Fax

(317) 888-1591

NPI assigned

Jun 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Merit-based Incentive Payment System (MIPS)

Final score

73.17 of 100Reported as group

Quality

65.64

Improvement activities

40

Cost

56.38

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Joel H Hurt MD PLLC

  • Orthopaedic Surgery Physician
  • Austin, TX
  • NPI 1083204242
  Medicare reassignment

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1376587600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11675 JOLLYVILLE RD STE 207",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594105",
            "telephone_number": "512-856-1000",
            "fax_number": "317-888-1591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11675 JOLLYVILLE RD STE 207",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594105",
            "telephone_number": "512-856-1000",
            "fax_number": "317-888-1591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10000840A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "8Y9381",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Tabisz
• Lizette Taboada-Vance, RD
• Morgan Alyssa Tabor
• Mara S. Tache, MD
• Sachiko Tachibana, L.AC.
• Ryan Tackett
• Stephanie Louise Tacquard, M.D.
• Roozbeh Taeed, MD
• Madison Elizabeth Taff, PHARMD
• Tiffany Taff, MS, CF-SLP

• Physician Assistant in Austin, TX
• Providers in Austin, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.