Individual provider Active NPI

Jeffrey Wade Hutchinson, M.D.

  • Pediatric Adolescent Medicine Physician
  • Austin, TX
National Provider Identifier
1477545408
Registry record updated Feb 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
R8914 Issued in TX
Practice address
1101 Camino la Costa
Austin, TX 78752-3930
Phone
(512) 684-1832
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X MD9244 HI
Pediatric Adolescent Medicine Physician 2080A0000X R8914 TX Primary

Addresses

Primary practice location

1101 Camino la Costa
Austin, TX 78752-3930

Mailing address

1101 Camino la Costa
Austin, TX 78752-3930
Phone (512) 684-1832

Other practice location 1

Nnmc, Adolescent Department
8901 Wisconsin Ave
Bethesda, MD 20889-0001
Phone (301) 295-6168

Other identifiers 1

IdentifierTypeStateIssuer
766253MedicaidTX

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190221000115 TX Practitioner - Pediatric Medicine 3870810245 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD9244HIMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peoples Community Clinic Inc CurrentSince Feb 4, 2019 Accepting new patients
People'S Community Clinic, Inc. CurrentSince Feb 4, 2019 Accepting new patients

Locations

1101 Camino La Costa
Austin, TX 78752
Phone (512) 478-4939

10335 US Highway 290 E
Manor, TX 78653
Phone (512) 278-4400

10335 US Highway 290 E
Bldg 35
Manor, TX 78653
Phone (512) 478-4939

Interoperability endpoints

  • Direct secure messaging: jhutchinson668522@direct.ochin.org

Organizations & group practices 2

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550793600000",
    "number": "1477545408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 CAMINO LA COSTA",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787523930",
            "telephone_number": "512-684-1832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 CAMINO LA COSTA",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787523930",
            "telephone_number": "512-684-1832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Nnmc, Adolescent Department",
            "address_2": "8901 Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208890001",
            "country_code": "US",
            "telephone_number": "301-295-6168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUTCHINSON",
        "first_name": "JEFFREY",
        "middle_name": "WADE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2019-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "HI",
            "license": "MD9244",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "TX",
            "license": "R8914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "766253",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.