Jason Robert Crockett, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA08628 Issued in TX

Practice address

7431 NW Loop 410 Ste 109
San Antonio, TX 78245-3597

Phone

(210) 477-7190

Fax

(210) 477-7195

NPI assigned

Mar 5, 2009

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 2

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

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Methodist Carenow Urgent Care PLLCGroup PAC ID 3274808043, 71 clinicians

Practice addresses (Care Compare)

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.

• Methodist Carenow Urgent Care PLLC

  • Family Medicine Physician
  • San Antonio, TX
  • NPI 1083154207
  Medicare reassignment Care Compare group
• TMC Provider Group PLLC

  • Urgent Care Clinic/Center
  • San Antonio, TX
  • NPI 1053784660
  Medicare reassignment
• TMC Provider Group PLLC

  • Urgent Care Clinic/Center
  • San Antonio, TX
  • NPI 1033968789
  NPD
• TMC Provider Group PLLC

  • Urgent Care Clinic/Center
  • Round Rock, TX
  • NPI 1376908178
  NPD

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

{
    "created_epoch": "1236211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587340800000",
    "number": "1497995245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2961 MOSSROCK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782305119",
            "telephone_number": "210-731-4800",
            "fax_number": "210-731-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7431 NW LOOP 410 STE 109",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782453597",
            "telephone_number": "210-477-7190",
            "fax_number": "210-477-7195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6157 NW Loop 410",
            "address_2": "124",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "78238",
            "country_code": "US",
            "telephone_number": "210-523-1411",
            "fax_number": "210-523-9307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CROCKETT",
        "first_name": "JASON",
        "middle_name": "ROBERT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-05",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED MEDICAID",
            "identifier": "3560419-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED MEDICARE",
            "identifier": "484297YPLS",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krystal Croce, SLP-ASST
• Amy Faye Crocker, PT, DPT, OCS
• Nicole Crocker
• Christie Sue Crockett, PHARM.D, RPH
• Elizabeth Ann Crockett, FNP
• Kimberly Crockett
• Richard William Crockett, M.D.
• Judith Maria Croeser, RRT
• Harry Allen Croft
• Kristi Crofts, FNP

• Physician Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.
• 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.