Individual provider Active NPI

Kaitlin Jurcisin, CAA

  • Anesthesiologist Assistant
  • Washington, DC
National Provider Identifier
1659824738
Registry record updated Jul 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
AA000073 Issued in DC
Practice address
1331 4TH St SE Apt 1016
Washington, DC 20003-4479
Phone
(216) 299-1568
NPI assigned
Jul 26, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X AA000073 DC Primary

Addresses

Primary practice location

1331 4TH St SE Apt 1016
Washington, DC 20003-4479

Mailing address

1331 4TH St SE Apt 1016
Washington, DC 20003-4479
Phone (216) 299-1568

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180629000779 TX Practitioner - Anesthesiology Assistant 4587951991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Austin Anesthesiology Group PLLCGroup PAC ID 0547256497, 430 clinicians

Practice addresses (Care Compare)

8140 N Mopac Expressway
BLDG 3 Suite 210
Austin, TX 78759-8859
Phone (512) 343-2292

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
4003TXMDPsychologist
AA000073DCMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Austin Anesthesiology Group, PLLC Anesthesiologist Assistant CurrentSince Jun 5, 2018 Accepting new patients
Austin Anesthesiology Group PLLC CurrentSince Jun 5, 2018 Accepting new patients

Locations

4307 James Casey St
Austin, TX 78745
Phone (512) 416-6005

8140 N Mopac Expy
Bldg 3
Austin, TX 78759
Phone (512) 343-2292

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 342-2382

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

12201 Renfert Way
Ste 120
Austin, TX 78758
Phone (512) 454-6753

1201 W Louis Henna Blvd
Austin, TX 78681
Phone (512) 248-7000

12200 Renfert Way
Ste G-2
Austin, TX 78758
Phone (512) 901-8340

1111 W 34th St
Austin, TX 78705
Phone (512) 343-2466

8140 N Mopac Expy
Ste 3-210
Austin, TX 78759
Phone (512) 343-2292

900 W 38th St
Ste 200
Austin, TX 78705
Phone (512) 323-2061

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

16030 Park Valley Dr
Ste 100
Round Rock, TX 78681
Phone (512) 246-8777

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469491200000",
    "number": "1659824738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 4TH ST SE APT 1016",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200034479",
            "telephone_number": "216-299-1568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 4TH ST SE APT 1016",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200034479",
            "telephone_number": "216-299-1568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURCISIN",
        "first_name": "KAITLIN",
        "credential": "CAA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-26",
        "last_updated": "2016-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "DC",
            "license": "AA000073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.