Stephanie Jasik, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA05048 Issued in TX

Practice address

1110 N Sarah Dewitt Dr
Gonzales, TX 78629-3311

Phone

(830) 672-8502

Fax

(830) 672-3035

NPI assigned

Aug 25, 2008

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Ascension Seton

  • Family Medicine Physician
  • Luling, TX
  • NPI 1215118609
  Medicare reassignment NPD
• Ascension Seton

  • Medicare Defined Swing Bed Hospital Unit
  • Smithville, TX
  • NPI 1598590101
  NPD

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1396992079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 587",
            "city": "GONZALES",
            "state": "TX",
            "postal_code": "786290587",
            "telephone_number": "830-672-8502",
            "fax_number": "830-672-3035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 N SARAH DEWITT DR",
            "city": "GONZALES",
            "state": "TX",
            "postal_code": "786293311",
            "telephone_number": "830-672-8502",
            "fax_number": "830-672-3035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 W William Cannon Dr",
            "address_2": "Suite 401",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787455281",
            "country_code": "US",
            "telephone_number": "512-416-7246",
            "fax_number": "512-275-2833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JASIK",
        "first_name": "STEPHANIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-25",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA05048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "321101302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Hill
• Shannon Hines
• Commie L. Hisey, D.O.
• Valerie Magana Hohenshell, FNP
• Kelly B Huerra
• Sandra Johnston
• Gloria Martha Juarez
• Satya Kantipudi
• Catina Denise Kistler, CPHT
• Stephanie Lois Kodack, M.D.

• Medical Physician Assistant in Gonzales, TX
• Providers in Gonzales, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.