Individual provider Active NPI

Nicolette Julson, PA-C

  • Physician Assistant
  • Round Rock, TX
National Provider Identifier
1457870248
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16505 Issued in TX
Practice address
302 University Blvd
Round Rock, TX 78665-1032
Phone
(512) 509-0200
Fax
(512) 218-6330
NPI assigned
Sep 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00445300 NJ
Physician Assistant 363A00000X PA16505 TX Primary

Addresses

Primary practice location

302 University Blvd
Round Rock, TX 78665-1032

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111

Other practice location 1

94 Old Short Hills Rd
Livingston, NJ 07039-5672
Phone (973) 322-5000

Other practice location 2

300 Central Ave
East Orange, NJ 07018-2819
Phone (973) 672-8400

Other practice location 3

111 Central Ave
Newark, NJ 07102-1909
Phone (973) 877-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address njulson1245722@direct.sw.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171128001453 NJ Practitioner - Physician Assistant 7517224611 Reassigns benefits to 1 organization
I20231108000817 TX Practitioner - Physician Assistant 7517224611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

1701 E Pflugerville Pkwy
Baylor Scott and White Clinic Pflug
Pflugerville, TX 78660-8990
Phone (512) 259-6000

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

300 University Blvd
Round Rock, TX 78665-1032
Phone (512) 509-0200

302 University Blvd
Round Rock, TX 78665-1032
Phone (512) 509-0200

425 University Blvd
Round Rock, TX 78665-1053
Phone (512) 509-0200

5245 W Hwy 290
Baylor Scott and White Medical Center Austi
Austin, TX 78735-8963
Phone (512) 654-2100

5251 W Hwy 290
Baylor Scott and White Clinic Austin Oak Hi
Austin, TX 78735-8963
Phone (512) 654-3000

5251 W Hwy 290 100
Baylor Scott and White Cancer and Infusion Ce
Austin, TX 78735-8963
Phone (512) 654-4319

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00445300NJMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Hospital - Taylor Past Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1457870248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 UNIVERSITY BLVD",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786651032",
            "telephone_number": "512-509-0200",
            "fax_number": "512-218-6330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "94 Old Short Hills Rd",
            "address_purpose": "LOCATION",
            "city": "Livingston",
            "state": "NJ",
            "postal_code": "070395672",
            "country_code": "US",
            "telephone_number": "973-322-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Central Ave",
            "address_purpose": "LOCATION",
            "city": "East Orange",
            "state": "NJ",
            "postal_code": "070182819",
            "country_code": "US",
            "telephone_number": "973-672-8400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071021909",
            "country_code": "US",
            "telephone_number": "973-877-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JULSON",
        "first_name": "NICOLETTE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-13",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00445300",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA16505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "njulson1245722@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "302 University Blvd",
            "city": "Round Rock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786651032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.