Marcie Bennett, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA02823 Issued in TX

Practice address

4775 Hamilton Wolfe Rd Ste 1
San Antonio, TX 78229-3456

Phone

(210) 616-0283

Fax

(210) 616-0071

NPI assigned

Feb 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jagannath LLCGroup PAC ID 3971668351, 12 clinicians

Quality Care Clinic LLCGroup PAC ID 3779742713, 10 clinicians

Sona LLC of TexasGroup PAC ID 3870618622, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Jagannath LLC

  • Urgent Care Clinic/Center
  • San Antonio, TX
  • NPI 1700038239
  Medicare reassignment Care Compare group
• Quality Care Clinic LLC

  • Urgent Care Clinic/Center
  • San Antonio, TX
  • NPI 1497034946
  Medicare reassignment Care Compare group
• Sona LLC of Texas

  • Urgent Care Clinic/Center
  • Schertz, TX
  • NPI 1598087207
  Medicare reassignment Care Compare group
• Viva Pediatrics PA

  • Pediatrics Physician
  • San Antonio, TX
  • NPI 1790833291
  NPD (past)

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1992846323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4775 HAMILTON WOLFE RD STE 1",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293456",
            "telephone_number": "210-616-0283",
            "fax_number": "210-616-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4775 HAMILTON WOLFE RD STE 1",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293456",
            "telephone_number": "210-616-0283",
            "fax_number": "210-616-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "MARCIE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PA02823",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Girly Bennett, M.D.
• Jason M. Bennett, M.D.
• John Anthony Bennett, CCP
• Kinneathea Denisha Bennett, NURSE PRACTITIONER
• Linda Bennett, LCSW
• Penny Bennett, PHD, MSN, NNP-BC, FN
• Robert Daniel Bennett, MD
• Sarah Elizabeth Bennett
• Traci Leigh Bennett, RBT-25-419661
• Amy Renee Bennie, PSYD

• Physician Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.