Individual provider Active NPI

Kristen Marie Neumann, PA-C

  • Physician Assistant
  • Cedar Park, TX
National Provider Identifier
1609245968
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10098 Issued in TX
Practice address
1515 Medical Pkwy Ste 100
Cedar Park, TX 78613-2776
Phone
(125) 260-5860
NPI assigned
Sep 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10098 TX Primary

Addresses

Primary practice location

1515 Medical Pkwy Ste 100
Cedar Park, TX 78613-2776

Mailing address

1515 Medical Pkwy Ste 100
Cedar Park, TX 78613-2776
Phone (125) 260-5860

Other names 1

  • Kristen Neumann Potter Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161121000443 TX Practitioner - Physician Assistant 3375822026 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

1367 Dominion PLZ
Tyler, TX 75703-1013
Phone (903) 534-6200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10098TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mays MD PA PastSince Mar 20, 2025 Accepting new patients
Dermatology Associates Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1609245968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 MEDICAL PKWY STE 100",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132776",
            "telephone_number": "125-260-5860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 MEDICAL PKWY STE 100",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786132776",
            "telephone_number": "125-260-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUMANN",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-16",
        "last_updated": "2025-01-21",
        "certification_date": "2024-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "POTTER",
            "middle_name": "NEUMANN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cedar Park, TX

Sources for this page

Verify at the official NPI Registry.