Individual provider Active NPI

Jordan Taylor Gooch, PA-C

  • Physician Assistant
  • Live Oak, TX
National Provider Identifier
1992364970
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA12911 Issued in TX
Practice address
12850 Toepperwein Rd
Live Oak, TX 78233-4115
Phone
(210) 614-1234
NPI assigned
Jun 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA12911 TX Primary

Addresses

Primary practice location

12850 Toepperwein Rd
Live Oak, TX 78233-4115

Mailing address

8415 Datapoint Dr Ste 700
San Antonio, TX 78229-3327
Phone (210) 614-1234

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
I20190801001932 TX Practitioner - Physician Assistant 0547596272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Digestive Disease Consultants, PLLCGroup PAC ID 3375531379, 616 clinicians

Practice addresses (Care Compare)

12850 Toepperwein Rd
Live Oak, TX 78233-4115
Phone (210) 614-1234

5425 W Spring Creek Pkwy
Suite 205
Plano, TX 75024-4236
Phone (972) 526-5860

P O Box
Suite 35629
Dallas, TX 75235-0629

PO Box
Suite 35629
Dallas, TX 75235-0629

Hospital & facility affiliations

  • Methodist Hospital Stone Oak Hospital, San Antonio, TX, CCN 670055
  • Methodist Hospital Hospital, San Antonio, TX, CCN 450388

Merit-based Incentive Payment System (MIPS)

Final score
80.98 of 100Reported as group
Quality
66.51
Promoting interoperability
98
Improvement activities
40
Cost
71.76

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Digestive Disease Consultants, PLLC CurrentSince Feb 1, 2020 Accepting new patients
Gcsa Anesthesia PLLC PastSince Dec 15, 2019 Accepting new patients
Texas Digestive Disease Consultants, PLLC PastSince Dec 15, 2019 Accepting new patients

Locations

12850 Toepperwein Rd
Live Oak, TX 78233
Phone 2106141234713

5425 W Spring Creek Pkwy
Ste 205
Plano, TX 75024
Phone (972) 526-5860

18707 Hardy Oak Blvd
Ste 225
San Antonio, TX 78258
Phone (210) 657-0220

5223 Hamilton Wolfe Rd
San Antonio, TX 78229
Phone 2106141234713

855 Proton Rd
San Antonio, TX 78258
Phone (210) 582-8000

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 4

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": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1992364970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8415 DATAPOINT DR STE 700",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293327",
            "telephone_number": "210-614-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12850 TOEPPERWEIN RD",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782334115",
            "telephone_number": "210-614-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOCH",
        "first_name": "JORDAN",
        "middle_name": "TAYLOR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Live Oak, TX

Sources for this page

Verify at the official NPI Registry.