NPIMap

Organization Active NPI

City of Austin

  • Family Medicine Physician
  • Austin, TX
National Provider Identifier
1568635803
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CITY OF AUSTIN
Practice address
7500 Blessing Ave
Austin, TX 78752-1716
Phone
(512) 972-5554
Fax
(512) 978-7556
NPI assigned
Apr 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Authorized official

Name
Jesse Hernandez
Title
Customer Service Representative Sr
Phone
(512) 972-4421

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Community Health Clinic/Center 261QC1500X
State or Local Public Health Clinic/Center 261QP0905X

Addresses

Primary practice location

7500 Blessing Ave
Austin, TX 78752-1716

Mailing address

15 Waller St FL 3
Austin, TX 78702-5240
Phone (512) 972-4421

Other practice location 1

15 Waller St Fl 1
Austin, TX 78702-5240
Phone (737) 210-0296

Other practice location 2

15 Waller St Fl 3
Austin, TX 78702-5240
Phone (512) 972-4421

Other names 3

  • -HHSD Immunization Program Other name
  • APH Immunization Program Other name
  • APH STI/TB Program Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050201000602 TX Part B Supplier - Mass Immunization (Roster Biller Only) 7618969353 Practice locations: Austin, TX

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Northeast Austin Health9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1000 Toyath St
Austin, TX 78703
Phone (512) 972-4421

15 Waller St
#410
Austin, TX 78702

15 Waller St
Fl 3
Austin, TX 78702
Phone (512) 972-4421

15 Waller St
Fl 1
Austin, TX 78702
Phone (737) 210-0296

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1568635803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 WALLER ST FL 3",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787025240",
            "telephone_number": "512-972-4421",
            "fax_number": "512-978-7556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 BLESSING AVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787521716",
            "telephone_number": "512-972-5554",
            "fax_number": "512-978-7556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Waller St Fl 1",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787025240",
            "country_code": "US",
            "telephone_number": "737-210-0296",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15 Waller St Fl 3",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787025240",
            "country_code": "US",
            "telephone_number": "512-972-4421",
            "fax_number": "512-978-7556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CITY OF AUSTIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "CUSTOMER SERVICE REPRESENTATIVE SR",
        "authorized_official_telephone_number": "512-972-4421"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "-HHSD Immunization Program",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "APH Immunization Program",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "APH STI/TB Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.