Individual provider Active NPI

Jeffrey L. Scott, PA-C

  • Physician Assistant
  • Cibolo, TX
National Provider Identifier
1891897625
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA02211 Issued in TX
Practice address
791 FM 1103
Suite # 125
Cibolo, TX 78108
Phone
(210) 888-1175
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2016

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 PA02211 TX Primary

Addresses

Primary practice location

791 FM 1103
Suite # 125
Cibolo, TX 78108

Mailing address

791 FM 1103
Suite # 125
Cibolo, TX 78108
Phone (210) 888-1175

Other identifiers 3

IdentifierTypeStateIssuer
8370NTOtherTXBCBS
192969701MedicaidTX
82N653OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100923001077 TX Practitioner - Physician Assistant 9830215136 Reassigns benefits to 5 organizations
I20230223002689 NM Practitioner - Physician Assistant 9830215136

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Texas Ancillary Services LTDGroup PAC ID 1456677087, 28 clinicians
GMG Health Systems Associates PAGroup PAC ID 8123932647, 115 clinicians

Practice addresses (Care Compare)

711 Pleasanton Rd
San Antonio, TX 78214-1305
Phone (210) 921-6600

720 Pleasanton Rd
San Antonio, TX 78214-1306

7219 Culebra Rd
San Antonio, TX 78251-1305
Phone (210) 509-2603

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ucp Physicians of Central Texas, PLLC CurrentSince Dec 28, 2021 Accepting new patients
Fast Track Urgent Care - Bastrop Physician Assistant CurrentSince Mar 21, 2015 Accepting new patients
St. David'S Carenow Urgent Care PLLC Past Accepting new patients

Locations

6001 W William Cannon Dr
Ste 302
Austin, TX 78749
Phone (512) 288-3627

791 FM 1103
Ste 125
Cibolo, TX 78108
Phone (210) 888-1175

1331 Northpark Dr
Kingwood, TX 77339
Phone (281) 359-5330

1240 E Palm Valley Blvd
Round Rock, TX 78664
Phone (512) 733-9100

17910 Bulverde Rd
Ste 115
San Antonio, TX 78259
Phone (210) 906-8478

Organizations & group practices 8

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462233600000",
    "number": "1891897625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "791 FM 1103",
            "address_2": "SUITE # 125",
            "city": "CIBOLO",
            "state": "TX",
            "postal_code": "78108",
            "telephone_number": "210-888-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "791 FM 1103",
            "address_2": "SUITE # 125",
            "city": "CIBOLO",
            "state": "TX",
            "postal_code": "78108",
            "telephone_number": "210-888-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "JEFFREY",
        "middle_name": "L.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2016-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8370NT",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "192969701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "82N653",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cibolo, TX

Sources for this page

Verify at the official NPI Registry.