Andrea Pavia-Jimenez, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA12535 Issued in TX

Practice address

610 W Centerville Rd
Garland, TX 75041-5419

Phone

(214) 501-3494

NPI assigned

Nov 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Pedcare, PA

  • Pediatrics Physician
  • Mesquite, TX
  • NPI 1417177841
  NPD (past)

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

{
    "created_epoch": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1659841237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3230 I 30 STE 100",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751502662",
            "telephone_number": "972-682-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 W CENTERVILLE RD",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750415419",
            "telephone_number": "214-501-3494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVIA-JIMENEZ",
        "first_name": "ANDREA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-27",
        "last_updated": "2023-03-07",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "403452201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PA12535",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachael Nicole Patterson, LPC
• Aaron M Patton, DDS
• Paul K. Ozoigbo County Ambulances
• Paul M Garmon Jr DO PA
• Paulpath Psychiatry and Mental Health
• Mallory Nicole Payne
• Tanneatha Kaye Payton
• Peace Caring Services, LLC
• Peaceway Hospice LLC
• Peak Health Diagnostics, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.