Individual provider Active NPI

Jacqueline Vizcaino, AU.D.

  • Audiologist
  • San Antonio, TX
National Provider Identifier
1417574476
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
81162 Issued in TX
Practice address
4647 Medical Dr
San Antonio, TX 78229-4403
Phone
(210) 358-4583
Fax
(210) 358-2653
NPI assigned
Jun 25, 2020
Last updated
Aug 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 81162 TX
Audiologist 231H00000X 81162 TX Primary

Addresses

Primary practice location

4647 Medical Dr
San Antonio, TX 78229-4403

Mailing address

170 Babcock Rd
San Antonio, TX 78201-3806
Phone (210) 695-4708

Other practice location 1

170 Babcock Rd
San Antonio, TX 78201-3806
Phone (210) 695-4708

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200630002522 TX Practitioner - Qualified Audiologist 9133542632 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acro Audiology Hearing Care CenterGroup PAC ID 0547686545, 4 clinicians

Practice addresses (Care Compare)

21031 Market RDG
Suite 2
San Antonio, TX 78258-2483
Phone (210) 239-5995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
81162TXMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medicine Associates CurrentSince Jul 16, 2020 Accepting new patients
Acro Audiology Hearing Care Center Audiologist CurrentSince Jun 17, 2025 Accepting new patients
Pain Management Specialists CurrentSince Feb 7, 2021 Accepting new patients

Locations

111 W Hornbeck Blvd
Fort Stockton, TX 79735

109 W Hornbeck Blvd
Fort Stockton, TX 79735
Phone (432) 244-4311

21031 Market Rdg
Ste 2
San Antonio, TX 78258
Phone (210) 239-5995

903 W Martin St
#492
San Antonio, TX 78207
Phone (210) 358-3441

4647 Medical Dr
San Antonio, TX 78229
Phone (210) 358-2710

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1417574476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 BABCOCK RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782013806",
            "telephone_number": "210-695-4708",
            "fax_number": "210-695-4706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4647 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294403",
            "telephone_number": "210-358-4583",
            "fax_number": "210-358-2653"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "170 Babcock Rd",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782013806",
            "country_code": "US",
            "telephone_number": "210-695-4708",
            "fax_number": "210-695-4706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIZCAINO",
        "first_name": "JACQUELINE",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-25",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "TX",
            "license": "81162",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "81162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.