Jayasree Krishnankutty, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10762 Issued in TX

Practice address

1420 W Wells Branch Pkwy
Suite #450
Pflugerville, TX 78660-3101

Phone

(512) 806-0201

NPI assigned

May 24, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1400889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482364800000",
    "number": "1851703854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8585 SPICEWOOD SPRINGS RD",
            "address_2": "APT 1014",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787596863",
            "telephone_number": "408-348-0987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 W WELLS BRANCH PKWY",
            "address_2": "SUITE #450",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786603101",
            "telephone_number": "512-806-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISHNANKUTTY",
        "first_name": "JAYASREE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-24",
        "last_updated": "2016-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "51603",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA10762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Serawet Lake

• Physician Assistant in Pflugerville, TX
• Providers in Pflugerville, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2016; 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.

Verify at the official NPI Registry.