Individual provider Active NPI

Jennifer Bohannan

  • Surgical Physician Assistant
  • Burlingame, CA
National Provider Identifier
1912417676
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA68227 Issued in CA
Practice address
1501 Trousdale Dr
Burlingame, CA 94010-4506
Phone
(650) 696-5400
NPI assigned
Oct 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA68227 CA Primary

Addresses

Primary practice location

1501 Trousdale Dr
Burlingame, CA 94010-4506

Mailing address

PO Box 276950
Sacramento, CA 95827-6950

Other practice location 1

600 N Wolfe St
Baltimore, MD 21287-0005
Phone (410) 502-2651

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
I20240808002775 TX Practitioner - Physician Assistant 2769749472 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seton Family of DoctorsGroup PAC ID 0941333280, 785 clinicians

Practice addresses (Care Compare)

1004 W 32ND St
200 Ascension Texas Spine and Scoliosis
Austin, TX 78705-1006
Phone (512) 324-3580

1201 W 38TH St
Austin, TX 78705-1006
Phone (512) 324-1000

1400 N Ih 35
Austin, TX 78701-1926

1400 N Ih 35 LL
Cl400 Tri County Prac Assoc
Austin, TX 78701-1926
Phone (512) 324-7300

6001 Kyle Pkwy
Kyle, TX 78640-6112
Phone (512) 504-5000

Hospital & facility affiliations

  • Ascension Seton Medical Center Austin Hospital, Austin, TX, CCN 450056
  • Ascension Seton Hays Hospital, Kyle, TX, CCN 670056

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C06611MDMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Seton Family of Doctors CurrentSince Jun 7, 2024 Accepting new patients
Seton Family of Doctors CurrentSince Jun 7, 2024 Accepting new patients

Locations

1400 N Interstate 35
Ste 300
Austin, TX 78701
Phone (512) 324-8300

1004 W 32nd St
Ste 300
Austin, TX 78705
Phone (512) 324-3440

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

1180 Seton Pkwy
Ste 450
Kyle, TX 78640
Phone (512) 504-0860

Interoperability endpoints

  • Direct secure messaging: jennifer.bohannan.1@8363.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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1507507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1912417676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 276950",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958276950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 TROUSDALE DR",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940104506",
            "telephone_number": "650-696-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 N Wolfe St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212870005",
            "country_code": "US",
            "telephone_number": "410-502-2651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOHANNAN",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-09",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA68227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

Verify at the official NPI Registry.