Active NPI
Jack L. Seaquist, M.D.
- Orthopaedic Surgery Physician
- Austin, TX
National Provider Identifier
1699705145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- D9654
- Practice address
- 1301 W. 38TH St. #102
Austin, TX 78705-1010 - Phone
- (512) 454-4561
- Fax
- (512) 467-2906
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | D9654 | TX | Primary |
Addresses
Primary practice location
1301 W. 38TH St. #102
Austin, TX 78705-1010
Mailing address
PO Box 26726
Austin, TX 78755-0726
Phone (512) 407-8686
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 117193604 | Medicaid | TX | |
| 817420 | Other | TX | SCOTT & WHITE |
| 817420 | Other | TX | BCBS |
| 094771502 | Medicaid | TX | |
| 4048662 | Other | TX | AETNA TRS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D9654 | TX | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Austin Regional Clinic, PA | Past | Accepting new patients | |
| Medical Park Orthopaedic Clinic | Orthopaedic Surgery | Past | Accepting new patients |
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.
-
- Durable Medical Equipment & Medical Supplies
- Austin, TX
- NPI 1659691624
-
- Orthopaedic Surgery Physician
- Austin, TX
- NPI 1124057344
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286928000000",
"number": "1699705145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 26726",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787550726",
"telephone_number": "512-407-8686",
"fax_number": "512-421-4489"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 W. 38TH ST. #102",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787051010",
"telephone_number": "512-454-4561",
"fax_number": "512-467-2906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEAQUIST",
"first_name": "JACK",
"middle_name": "L.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2010-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "TX",
"license": "D9654",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "117193604",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SCOTT & WHITE",
"identifier": "817420",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "817420",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "094771502",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA TRS",
"identifier": "4048662",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.