Individual provider Active NPI

Steven Anthony Jaeckle, PA-C

  • Physician Assistant
  • Cedar Park, TX
National Provider Identifier
1881009579
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA14927 Issued in TX
Practice address
1779 E Whitestone Blvd BLDG 2
Cedar Park, TX 78613-6934
Phone
(512) 652-0050
Fax
(737) 220-7850
NPI assigned
Jun 22, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA14927 TX Primary
Physician Assistant 363A00000X 017575 NY
Physician Assistant 363A00000X PA1734 NV

Addresses

Primary practice location

1779 E Whitestone Blvd BLDG 2
Cedar Park, TX 78613-6934

Mailing address

6406 N Ih 35 Ste 2600
Austin, TX 78752-4337
Phone (512) 465-4800

Other identifiers 1

IdentifierTypeStateIssuer
1881009579MedicaidNV

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
I20221026001323 TX Practitioner - Physician Assistant 2860610581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Practice addresses (Care Compare)

601 Crystal Falls Pkwy
Suite 100
Leander, TX 78641-3613
Phone (512) 259-5111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017575NYMDMassage Therapist
PA1734NVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA CurrentSince Jul 17, 2022 Accepting new patients
Wellmed Medical Group, P.a. CurrentSince Jul 17, 2022 Accepting new patients

Locations

1779 E Whitestone Blvd
Bldg 2
Cedar Park, TX 78613
Phone (512) 652-0050

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

Interoperability endpoints

  • Direct secure messaging: steven.jaeckle@wellmed.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1403395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759190400000",
    "number": "1881009579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6406 N IH 35 STE 2600",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787524337",
            "telephone_number": "512-465-4800",
            "fax_number": "512-420-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1779 E WHITESTONE BLVD BLDG 2",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786136934",
            "telephone_number": "512-652-0050",
            "fax_number": "737-220-7850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAECKLE",
        "first_name": "STEVEN",
        "middle_name": "ANTHONY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-22",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA14927",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017575",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1734",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881009579",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

Verify at the official NPI Registry.