Jeremy Alan Padalecki, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

P1801 Issued in TX

Practice address

1100 Teravista Xing
Georgetown, TX 78626-7704

Phone

(210) 861-9691

NPI assigned

May 5, 2010

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Frio Hospital Association

  • Critical Access Hospital Clinic/Center
  • Pearsall, TX
  • NPI 1952308132

  Emergency Medicine

  Medicare reassignment NPD
• Frio Hospital Association

  • Clinic/Center
  • Pearsall, TX
  • NPI 1053195032
  NPD
• Brazos Valley ER, LLC

  • Emergency Care Clinic/Center
  • Bryan, TX
  • NPI 1710417761
  NPD (past)
• USA Emergency Centers - Clear Lake, LLC

  • Emergency Care Clinic/Center
  • Houston, TX
  • NPI 1891210639
  NPD (past)

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

{
    "created_epoch": "1273017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443484800000",
    "number": "1497073209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 TERAVISTA XING",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786267704",
            "telephone_number": "210-861-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 TERAVISTA XING",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786267704",
            "telephone_number": "210-861-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADALECKI",
        "first_name": "JEREMY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-05",
        "last_updated": "2015-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "P1801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie D Overby-Anaya, DPM
• Gail M Overton, MS, LN
• Jessica Lauren Oviedo, PT, DPT
• Mariah Owen, LCSW
• Aabha Oza, M.D.
• Benjamin Page, DC
• Lori L Palazzo, M.D.
• Alexander David Pallante, PMHNP-BC
• Palmer Eyecare, Inc
• Lori Danelle Palmer, O.D.

• Emergency Medicine Physician in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2015; 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.