Individual provider Active NPI

Jason Raine Pickett, M.D.

  • Emergency Medicine Physician
  • Austin, TX
National Provider Identifier
1679624043
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
13823854-1205 Issued in UT
Practice address
4201 Ed Bluestein Blvd
Austin, TX 78721-2909
Phone
(512) 978-0000
NPI assigned
Jan 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Paramedic 146L00000X P0948731 OH
Emergency Medicine Physician 207P00000X 27856 WV
Emergency Medicine Physician 207P00000X 35.089152 OH
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 35.089152 OH
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X R4766 TX
Emergency Medicine Physician 207P00000X 13823854-1205 UT Primary

Addresses

Primary practice location

4201 Ed Bluestein Blvd
Austin, TX 78721-2909

Mailing address

4201 Ed Bluestein Blvd
Austin, TX 78721-2909
Phone (512) 978-0000

Other practice location 1

1 Wyoming St
Dayton, OH 45409-2722
Phone (937) 208-3356

Other practice location 2

2194 Booth Rd
Kenova, WV 25530-9544
Phone (937) 825-0663

Other identifiers 1

IdentifierTypeStateIssuer
272983MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jpickett700517@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, TX, UT3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20070327000184 OH Practitioner - Emergency Medicine 0446354765 Reassigns benefits to 1 organization
I20171026000913 TX Practitioner - Emergency Medicine 0446354765 Reassigns benefits to 2 organizations
I20240529002386 UT Practitioner - Emergency Medicine 0446354765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Eastern Virginia Medical School, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 585-6387

Hospital & facility affiliations

  • University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
P0948731OHMDParamedic
27856WVMDEmergency Medicine Physician
35.089152OHMDEmergency Medical Services (Emergency Medicine) Physician
R4766TXMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Longhorn Emergency Medical Associates PA Emergency Medicine CurrentSince Jan 25, 2024 Accepting new patients
Travis County Emergency Physicians PA Emergency Medicine CurrentSince Nov 1, 2018 Accepting new patients
University of Utah Adult Services CurrentSince May 1, 2024 Accepting new patients
Miami Valley Emergency Specialists, LLC Emergency Medicine CurrentSince Feb 14, 2007 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince May 1, 2024 Accepting new patients

Locations

2400 Lakeview Dr
#150
Beavercreek, OH 45431

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

2400 Miami Valley Dr
Dayton, OH 45459
Phone (937) 208-8394

9000 N Main St
Englewood, OH 45415
Phone (937) 208-8394

4940 Cottonville Rd
Jamestown, OH 45335
Phone (937) 298-4417

300 Austin West Blvd
Miamisburg, OH 45342
Phone (937) 388-7911

1 Medical Center Dr
Middletown, OH 45005
Phone (513) 424-2111

3130 N County Road 25A
Troy, OH 45373
Phone (937) 440-4000

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

7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305

1500 Red River St
Austin, TX 78701
Phone (512) 324-0150

630 W State Highway 71
Bastrop, TX 78602
Phone (737) 881-7400

2615 Southwest Fwy
Ste 140
Houston, TX 77098
Phone (713) 441-2779

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

1310 E League City Pkwy
League City, TX 77573
Phone (346) 427-5050

11525 Broadway St
Pearland, TX 77584
Phone (713) 363-8020

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

3011 W Loop 1604 N
San Antonio, TX 78251
Phone (726) 266-7081

127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Organizations & group practices 6

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 3

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": "1168732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1679624043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 ED BLUESTEIN BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787212909",
            "telephone_number": "512-978-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 ED BLUESTEIN BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787212909",
            "telephone_number": "512-978-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Wyoming St",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454092722",
            "country_code": "US",
            "telephone_number": "937-208-3356",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2194 Booth Rd",
            "address_purpose": "LOCATION",
            "city": "Kenova",
            "state": "WV",
            "postal_code": "255309544",
            "country_code": "US",
            "telephone_number": "937-825-0663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PICKETT",
        "first_name": "JASON",
        "middle_name": "RAINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-14",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146L00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "OH",
            "license": "P0948731",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "27856",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.089152",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "OH",
            "license": "35.089152",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "R4766",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "13823854-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272983",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpickett700517@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.