Individual provider Active NPI

Pierce McKinnon Neitzke, PA-C

  • Medical Physician Assistant
  • Austin, TX
National Provider Identifier
1982102430
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA15785 Issued in TX
Practice address
2525 Wallingwood Dr Ste 200
Austin, TX 78746-6937
Phone
(512) 744-5489
NPI assigned
Jan 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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 0010-07905 NC
Surgical Physician Assistant 363AS0400X 0010-07905 NC
Medical Physician Assistant 363AM0700X PA15785 TX Primary

Addresses

Primary practice location

2525 Wallingwood Dr Ste 200
Austin, TX 78746-6937

Mailing address

2525 Wallingwood Dr Ste 200
Austin, TX 78746-6937
Phone (512) 744-5489

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
I20221107001968 TX Practitioner - Physician Assistant 0648534222 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
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 Williamson Hospital, Round Rock, TX, CCN 670041

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA15785TXMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Seton Family of Doctors CurrentSince Mar 25, 2024 Accepting new patients
Seton Family of Doctors CurrentSince Mar 25, 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

1401 Medical Pkwy
Cedar Park, TX 78613
Phone (512) 528-7000

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

Interoperability endpoints

  • Direct secure messaging: pierce.neitzke.1@8363.direct.athenahealth.com

Organizations & group practices 3

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": "1517270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1982102430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 WALLINGWOOD DR STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787466937",
            "telephone_number": "512-744-5489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 WALLINGWOOD DR STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787466937",
            "telephone_number": "512-744-5489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEITZKE",
        "first_name": "PIERCE",
        "middle_name": "MCKINNON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-30",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07905",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-07905",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA15785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.