Individual provider Active NPI

Julie Elizabeth Jackson, M.D.

  • Dermatology Physician
  • Austin, TX
National Provider Identifier
1982863510
Registry record updated Feb 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
P5084 Issued in TX
Practice address
8825 Bee Caves Rd Ste 100
Austin, TX 78746-4721
Phone
(512) 328-3376
Fax
(512) 540-5397
NPI assigned
Jun 9, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X P5084 TX Primary
Dermatopathology Physician 207ND0900X P5084 TX

Addresses

Primary practice location

8825 Bee Caves Rd Ste 100
Austin, TX 78746-4721

Mailing address

8825 Bee Caves Rd Ste 100
Austin, TX 78746-4721
Phone (512) 328-3376

Other identifiers 1

IdentifierTypeStateIssuer
P5084OtherTXSTATE LICENSE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130803000178 TX Practitioner - Dermatology 7113169129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Texas Medical Branch at Galveston, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Westlake Dermatology PAGroup PAC ID 6305817230, 52 clinicians

Practice addresses (Care Compare)

1760 Round Rock Ave
Round Rock, TX 78681-4217
Phone (512) 583-3376

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision18
Removal of skin lesions227
Removal or shaving of skin growth1-10
Skin biopsy153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Westlake Dermatology, PA Dermatology CurrentSince Jul 1, 2013 Accepting new patients
Westlake Dermatology PA Dermatology Current Accepting new patients
Westlake Dermatology PA Dermatology CurrentSince Jul 1, 2013 Accepting new patients
Cardiovascular Research Associates PA Past Accepting new patients

Locations

8825 Bee Caves Rd
Austin, TX 78746
Phone (512) 454-3333

12201 Renfert Way
Ste 305
Austin, TX 78758
Phone (513) 279-3376

8825 FM 2244 Rd
Ste 100
Austin, TX 78746

401 S FM 620 Rd
Ste 200
Lakeway, TX 78734
Phone (512) 610-0549

1760 Round Rock Ave
Round Rock, TX 78681
Phone (512) 583-3376

Organizations & group practices 4

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": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549584000000",
    "number": "1982863510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8825 BEE CAVES RD STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787464721",
            "telephone_number": "512-328-3376",
            "fax_number": "512-666-3767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8825 BEE CAVES RD STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787464721",
            "telephone_number": "512-328-3376",
            "fax_number": "512-540-5397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "JULIE",
        "middle_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-09",
        "last_updated": "2019-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "P5084",
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "TX",
            "license": "P5084",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "P5084",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.