Individual provider Active NPI

Jose L. Palacios Jr., OTR

  • Occupational Therapist
  • Austin, TX
National Provider Identifier
1376734608
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
114393 Issued in TX
Practice address
4712 Hoffman Dr
Austin, TX 78749-3602
Phone
(210) 286-5329
NPI assigned
Aug 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 114393 TX Primary

Addresses

Primary practice location

4712 Hoffman Dr
Austin, TX 78749-3602

Mailing address

4712 Hoffman Drive
Austin, TX 78749
Phone (210) 286-5329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200406001124 TX Practitioner - Occupational Therapist in Private Practice 3870922214 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Feb 18, 2020 Accepting new patients
Freedom Choice Holdings LLC Occupational Therapist CurrentSince Sep 8, 2025 Accepting new patients
Legacy Healthcare Services Inc. Occupational Therapist CurrentSince Feb 18, 2020 Accepting new patients
Adaptive Rehabilitation Clinics, LLC Occupational Therapist Past Accepting new patients
Freedom Home Health and Wellness PastSince Jul 24, 2022 Accepting new patients

Locations

110 Horizon Dr
#310
Raleigh, NC 27615

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

Organizations & group practices 5

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": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1376734608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4712 HOFFMAN DRIVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78749",
            "telephone_number": "210-286-5329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4712 HOFFMAN DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787493602",
            "telephone_number": "210-286-5329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALACIOS",
        "first_name": "JOSE",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "114393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.