Individual provider Active NPI

Gladys A Huertas, PA

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1700848587
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA04029 Issued in TX
Practice address
11300 N Lamar Blvd
Austin, TX 78753-2665
Phone
(512) 835-6751
NPI assigned
Apr 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA04029 TX Primary

Addresses

Primary practice location

11300 N Lamar Blvd
Austin, TX 78753-2665

Mailing address

11300 N Lamar Blvd
Austin, TX 78753-2665
Phone (512) 835-6751

Other identifiers 1

IdentifierTypeStateIssuer
8N9123OtherTXBLUE SHIELD

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040726001212 TX Practitioner - Physician Assistant 2668442971 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Davids Carenow Urgent Care PLLCGroup PAC ID 4284918418, 101 clinicians
Doctors Express of the Beaumont Area PAGroup PAC ID 5698816882, 211 clinicians

Practice addresses (Care Compare)

10001 Research Blvd
Suite 100
Austin, TX 78759-5800
Phone (512) 993-3270

10625 W Parmer LN
Suite D400
Austin, TX 78717-4016
Phone (512) 361-6085

12415 N
Suite 35
Austin, TX 78753-1326
Phone (737) 205-1270

14008 Shadowglen Blvd
Suite 100
Manor, TX 78653-3406
Phone (512) 514-1020

3607 Manor Rd
Suite 100
Austin, TX 78723-5818
Phone (512) 928-4600

4810 Gattis School Rd
Suite 100
Hutto, TX 78634-2037
Phone (512) 312-7230

5033 W Hwy 290
Carenow
Austin, TX 78735-6751
Phone (512) 265-8980

6600 S Mopac Expy
Suite 2180
Austin, TX 78749-1430
Phone (512) 522-3010

7212 Burnet Rd
Austin, TX 78757-2253
Phone (512) 867-6299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA04029TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southlake Doctors Express, PA PSC Current Accepting new patients
Doctors Express of the Temple Area, PA Past Accepting new patients

Locations

2315 E Southlake Blvd
Ste 110
Southlake, TX 76092
Phone (817) 488-9922

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1700848587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11300 N LAMAR BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787532665",
            "telephone_number": "512-835-6751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11300 N LAMAR BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787532665",
            "telephone_number": "512-835-6751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUERTAS",
        "first_name": "GLADYS",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "8N9123",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.