Individual provider Active NPI

Jessica Kondratenko, PA-C

  • Physician Assistant
  • Round Rock, TX
National Provider Identifier
1881456879
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19374 Issued in TX
Practice address
2000 S Mays St Ste 201
Round Rock, TX 78664-7580
Phone
(512) 244-4272
Fax
(512) 244-2895
NPI assigned
Jan 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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 PA19374 TX Primary

Addresses

Primary practice location

2000 S Mays St Ste 201
Round Rock, TX 78664-7580

Mailing address

101 W Louis Henna Blvd Ste 300
Austin, TX 78728-1203
Phone (512) 244-4272

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
I20250812002633 TX Practitioner - Physician Assistant 9830697556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Missouri, Kansas City, School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mark Malone MD PAGroup PAC ID 2567369424, 102 clinicians

Practice addresses (Care Compare)

1106 College St
Suite C
Bastrop, TX 78602-3948
Phone (512) 244-4272

2000 S Mays St
Round Rock, TX 78664-7580
Phone (512) 244-4272

3418 N Lamar Blvd
Suite 100
Austin, TX 78705-1116
Phone (512) 244-4272

6000 S Mopac
Suite 100
Austin, TX 78749
Phone (512) 244-4272

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA19374TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Malone, MD PA CurrentSince Jul 24, 2025 Accepting new patients
Mark Malone MD PA Physician Assistant Past Accepting new patients

Locations

3418 N Lamar Blvd
Ste 100
Austin, TX 78705

101 W Louis Henna Blvd
Ste 300
Austin, TX 78728

6000 S Mopac Expy
Ste 100
Austin, TX 78749

1106 College St
Ste C
Bastrop, TX 78602
Phone (512) 244-2895

2000 S Mays St
Ste 201
Round Rock, TX 78664
Phone (512) 492-3743

Interoperability endpoints

  • Direct secure messaging: jessica.kondratenko.1@24201.direct.athenahealth.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": "1706140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1881456879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W LOUIS HENNA BLVD STE 300",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787281203",
            "telephone_number": "512-244-4272",
            "fax_number": "512-244-2895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S MAYS ST STE 201",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786647580",
            "telephone_number": "512-244-4272",
            "fax_number": "512-244-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONDRATENKO",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-25",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA19374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

Verify at the official NPI Registry.