Individual provider Active NPI

Kaylee Czarnecki, PA-C

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1619856481
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
16406 Pemoak Dr
San Antonio, TX 78240-5607
Phone
(210) 787-0484
NPI assigned
Aug 27, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 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 Primary

Addresses

Primary practice location

16406 Pemoak Dr
San Antonio, TX 78240-5607

Mailing address

16406 Pemoak Dr
San Antonio, TX 78240-5607
Phone (210) 787-0484

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
I20260528002757 TX Order and Referring Only - Physician Assistant 1153891304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1756252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1619856481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16406 PEMOAK DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782405607",
            "telephone_number": "210-787-0484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16406 PEMOAK DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782405607",
            "telephone_number": "210-787-0484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZARNECKI",
        "first_name": "KAYLEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.