Jerald L Wells, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA01379 Issued in TX

Practice address

3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504

Phone

(210) 539-9582

Fax

(210) 916-5102

NPI assigned

Aug 14, 2006

Sex

Male

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

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.

• Alamo City Urgent Care, LLC

  • Urgent Care Clinic/Center
  • San Antonio, TX
  • NPI 1245721406
  Medicare reassignment NPD
• University of Texas Health Science Center at San Antonio

  dba UT Health Physicians

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1720051717
  Medicare reassignment
• The University of Texas Health Science Center at San Antonio

  dba UT Health San Antonio Multispecialty & Research Hospital

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1326829904
  NPD
• University of Texas Health Science Center at San Antonio

  dba UT Health Imaging

  • Diagnostic Radiology Physician
  • Boerne, TX
  • NPI 1417921834
  NPD
• Greater San Antonio Emergency Physicians, PA

  • Emergency Medicine Physician
  • San Antonio, TX
  • NPI 1134184831
  NPD (past)

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1417960535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-539-9582",
            "fax_number": "210-916-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-539-9582",
            "fax_number": "210-916-5102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7703 Floyd Curl Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293901",
            "country_code": "US",
            "telephone_number": "210-257-1400",
            "fax_number": "210-257-1428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLS",
        "first_name": "JERALD",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA01379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190641402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chan Lee Webster, OD
• Erin Elisabeth Weidemann, P.A.-C
• Glenda Weidendorf, NNP
• Daniel J Weinstein, DO
• Nathan Weiss, D.O.
• Michael Joseph Wells, D.O.
• Shelena Inez Wells, MPAS-C
• Ronald Richard Werner, PA-C
• Oranetta Wesley Hall
• Peggy Dee Westerbeck-Silva, OTR/L

• Medical Physician Assistant in Fort Sam Houston, TX
• Providers in Fort Sam Houston, 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 Nov 30, 2020; 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.