Jenna L Kavanaugh, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA05983 Issued in TX

Practice address

1301 W 38TH St Ste 102
Austin, TX 78705-1010

Phone

(512) 454-4561

Fax

(512) 406-7330

NPI assigned

Dec 3, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Physician Assistant

Education

Other, 2008

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)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: jkavanaugh14035@arcmd.direct-ci.com

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.

• Austin Regional Clinic, PA

  • Family Medicine Physician
  • Austin, TX
  • NPI 1821157579
  Medicare reassignment Care Compare group
• Seton Hospitalist Service

  dba Adult Inpatient Medical Services

  • Internal Medicine Physician
  • Austin, TX
  • NPI 1013293679
  NPD (past)

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

{
    "created_epoch": "1228262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497398400000",
    "number": "1629213756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 SETON CENTER PKWY",
            "address_2": "SUITE 215",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787595290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 W 38TH ST STE 102",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051010",
            "telephone_number": "512-454-4561",
            "fax_number": "512-406-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAUGH",
        "first_name": "JENNA",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-03",
        "last_updated": "2017-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA05983",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200565403",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200565402",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Manminder Kaur
• Samheet Kaur, LCSW
• Deepika Kaushik, MA, LPC
• Emily Jordyn Kautz, NP
• Janet Elise Kautz, LCSW
• Regina Michelle Kavanaugh, LVN
• Parvin Kavehkar, DPT
• Alicia Kaveney, LPC, LCDC
• Babak Kaviani, D.P.M
• Keri Kaviani, PA

• Physician Assistant in Austin, TX
• Providers in Austin, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.