Individual provider Active NPI

Casey Boulanger Nelson, PA-C

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1548794027
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA14880 Issued in TX
Practice address
319 Congress Ave Ste 100
Austin, TX 78701-3692
Phone
(888) 663-6331
Fax
(415) 252-7176
NPI assigned
Apr 12, 2017
Last updated
Mar 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA14880 TX Primary
Physician Assistant 363A00000X 54312 CA

Addresses

Primary practice location

319 Congress Ave Ste 100
Austin, TX 78701-3692

Mailing address

PO Box 550
Yosemite National Park, CA 95389-0550
Phone (512) 663-3361

Other practice location 1

9000 Ahwahnee Drive
Yosemite National Park, CA 95389
Phone (209) 372-4637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, 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
I20170530001997 CA Practitioner - Physician Assistant 4587931225 Reassigns benefits to 1 organization
I20211101001192 TX Practitioner - Physician Assistant 4587931225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Seton Family of DoctorsGroup PAC ID 0941333280, 785 clinicians

Practice addresses (Care Compare)

1400 N Ih 35
Austin, TX 78701-1926

1400 N Ih 35 LL
Cl400 Tri County Prac Assoc
Austin, TX 78701-1926
Phone (512) 324-7300

319 Congress Ave
Suite 100
Austin, TX 78701-3692
Phone (512) 491-1095

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54312CAMDGeneral Practice Dentistry
PA14880TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Seton Family of Doctors CurrentSince Sep 20, 2021 Accepting new patients
Seton Family of Doctors CurrentSince Sep 20, 2021 Accepting new patients
US Dept of the Interior National Park Service CurrentSince Apr 18, 2017 Accepting new patients
One Medical Group of Texas, P.a. CurrentSince Nov 3, 2025 Accepting new patients
US Department of the Interior, National Park Service CurrentSince Apr 18, 2017 Accepting new patients
National Park Service Past Accepting new patients
Seton Family of Doctors Past Accepting new patients

Locations

1400 N Interstate 35
Ste 300
Austin, TX 78701
Phone (512) 324-8300

319 Congress Ave
Ste 100
Austin, TX 78701
Phone (512) 491-1095

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1548794027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "YOSEMITE NATIONAL PARK",
            "state": "CA",
            "postal_code": "953890550",
            "telephone_number": "512-663-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 CONGRESS AVE STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787013692",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9000 Ahwahnee Drive",
            "address_purpose": "LOCATION",
            "city": "Yosemite National Park",
            "state": "CA",
            "postal_code": "95389",
            "country_code": "US",
            "telephone_number": "209-372-4637",
            "fax_number": "209-372-4330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CASEY",
        "middle_name": "BOULANGER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-12",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA14880",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "54312",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.