Active NPI
Jacob Wareti, MD
- Pediatrics Physician
- Austin, TX
National Provider Identifier
1710776927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- BP10093770
- Practice address
- 4900 Mueller Blvd Ste 3J.018
Austin, TX 78723-3051 - Phone
- (512) 324-0067
- NPI assigned
- May 5, 2025
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | BP10093770 | TX | Primary |
Addresses
Primary practice location
4900 Mueller Blvd Ste 3J.018
Austin, TX 78723-3051
Mailing address
8030 Marilyn Rd
Reynoldsburg, OH 43068-3730
Phone (614) 557-6349
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250627003203 | TX | Order and Referring Only - Pediatric Medicine | 2567975063 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BP10093770 | TX | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1746403200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746403200000",
"number": "1710776927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8030 MARILYN RD",
"city": "REYNOLDSBURG",
"state": "OH",
"postal_code": "430683730",
"telephone_number": "614-557-6349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4900 MUELLER BLVD STE 3J.018",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787233051",
"telephone_number": "512-324-0067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARETI",
"first_name": "JACOB",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-05-05",
"last_updated": "2025-05-05",
"certification_date": "2025-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "BP10093770",
"primary": true
}
],
"identifiers": [],
"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 May 5, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.