Jessica Wilde, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4611 Guadalupe St Ste 200
Austin, TX 78751-2928

Phone

(512) 476-2830

Fax

(512) 476-2832

NPI assigned

Apr 18, 2014

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 names 1

• Jessica Thibodeaux Former name

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, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heinrich-Josey Orthopaedics, PLLCGroup PAC ID 1850362211, 22 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St David'S Medical Center Hospital, Austin, TX, CCN 450431
• Ascension Seton Medical Center Austin Hospital, Austin, TX, CCN 450056

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Heinrich-Josey Orthopaedics, P.L.L.C

  • Orthopaedic Surgery Physician
  • Austin, TX
  • NPI 1174571889
  Medicare reassignment Care Compare group NPD
• F Kelly Cunningham MD, PA

  • Sports Medicine (Orthopaedic Surgery) Physician
  • West Lake Hills, TX
  • NPI 1275912776
  Medicare reassignment
• St. David'S Ortho, Neuro and Rehab, PLLC

  • Orthopaedic Surgery Physician
  • Austin, TX
  • NPI 1669742755
  Medicare reassignment
• F Kelly Cunningham MD, PA

  • Sports Medicine (Orthopaedic Surgery) Physician
  • West Lake Hills, TX
  • NPI 1538525928
  NPD
• Heinrich-Josey Orthopaedics

  • Orthopaedic Surgery Physician
  • Leander, TX
  • NPI 1275330979
  NPD

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

• Ascension Seton

  • General Acute Care Hospital
  • Austin, TX
  • NPI 1164526786
  Care Compare affiliation
• St. Davids Healthcare Partnership, L.P., LLP

  • General Acute Care Hospital
  • Austin, TX
  • NPI 1720033947
  Care Compare affiliation

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

{
    "created_epoch": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1689094559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17510 DELL CITY DR",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786647255",
            "telephone_number": "979-204-1742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 GUADALUPE ST STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787512928",
            "telephone_number": "512-476-2830",
            "fax_number": "512-476-2832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDE",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-18",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "THIBODEAUX",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jonathan Wilcoxen, MT-BC
• Katherine Anne Wilcoxson, FNP-C
• Courtney Elizabeth Wild
• Rosemarie Wild, RDN, LD
• Dapo Wilde
• Wilder Wellness PLLC
• Alfred Christian Wilder, MD
• Andrea Wilder
• Justin Wilder, RN
• Katharina Ingeborg Leonore Wilder, APRN-C

• 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 Aug 11, 2021; 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.