Individual provider Active NPI

Jennifer Acosta, PA-C

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1619213691
Registry record updated Oct 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA08071 Issued in TX
Practice address
1807 W Slaughter LN Ste 490
Austin, TX 78748-6208
Phone
(512) 346-6611
Fax
(512) 406-7351
NPI assigned
Dec 20, 2012
Last updated
Oct 4, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2018

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 PA08071 TX Primary

Addresses

Primary practice location

1807 W Slaughter LN Ste 490
Austin, TX 78748-6208

Mailing address

4515 Seton Center Pkwy Ste 215
Austin, TX 78759-5785
Phone (512) 338-3826

Other identifiers 2

IdentifierTypeStateIssuer
387045301MedicaidTX
387045302MedicaidTX

Other names 1

  • Jennifer Lafleur 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
I20180806002219 TX Practitioner - Physician Assistant 3375798887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Austin Regional Clinic PAGroup PAC ID 3072507789, 398 clinicians

Practice addresses (Care Compare)

6835 Austin Ctr Blvd
Austin, TX 78731-3166
Phone (512) 346-6611

8901 Vertex Blvd
Suite 100
Austin, TX 78747-2792
Phone (512) 231-5150

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA08071TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Regional Clinic, PA CurrentSince Aug 16, 2018 Accepting new patients
Austin Regional Clinic, PA Physician Assistant CurrentSince Aug 16, 2018 Accepting new patients
Seton Hospitalist Service Past Accepting new patients

Locations

1807 W Slaughter Ln
Ste 490
Austin, TX 78748
Phone (512) 282-8967

6835 Austin Center Blvd
Austin, TX 78731
Phone (512) 231-5210

151 Exchange Blvd
Ste 500
Hutto, TX 78634
Phone (512) 846-1244

Interoperability endpoints

  • Direct secure messaging: jacosta20469@arcmd.direct-ci.com

Organizations & group practices 3

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": "1355961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538611200000",
    "number": "1619213691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 SETON CENTER PKWY STE 215",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787595785",
            "telephone_number": "512-338-3826",
            "fax_number": "512-406-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 W SLAUGHTER LN STE 490",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787486208",
            "telephone_number": "512-346-6611",
            "fax_number": "512-406-7351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-20",
        "last_updated": "2018-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA08071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "387045301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "387045302",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "LAFLEUR",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.