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TABITHA ANN CANTRELL
NPI 1104788736
Nurse Practitioner - Gerontology in Austin, TX

Active since December 02, 2025PECOS EnrolledAccepts Medicare Assignment
11624 JOLLYVILLE RD APT 538, AUSTIN, TX 78759(512) 680-5028 Get Directions Write a Review

NPPES record last updated: January 7, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 7, 2026, Dec 2, 2025 (2 updates tracked since 2025).

About Tabitha Ann Cantrell NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TABITHA ANN CANTRELL (NPI 1104788736) is an individual gerontology provider in Austin, Texas, licensed in Texas (1193337) and active in the NPI registry since December 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1104788736
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameTABITHA ANN CANTRELL
Location Address11624 JOLLYVILLE RD APT 538Austin, TX 78759-2455
Mailing Address11624 Jollyville Rd Apt 538Austin, TX 78759-2455
Phone(512) 680-5028
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateDecember 2, 2025
Last NPPES UpdateJanuary 7, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 7, 2026
✔ NPI 1104788736 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License✔ Licensed in TX · 1193337
Also ListedNurse PractitionerTaxonomy 363L00000X · License 1193337 (TX)
11624 JOLLYVILLE RD APT 538, Austin, TX 78759
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tabitha Ann Cantrell is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID648756205
PECOS Enrollment IDI20260113003523
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78759 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$89.03 typical visit price
range $57.88 – $174.00
Typical copayment $22.25 (range $14.47 – $43.50)
Most-billed visit code 99203
Established Patient
$101.65 typical visit price
range $18.88 – $142.23
Typical copayment $25.41 (range $4.72 – $35.55)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tabitha Cantrell's NPI number?

The NPI number for Tabitha Cantrell is 1104788736. It was assigned to this individual provider in the NPPES registry on December 2, 2025.

Where is Tabitha Cantrell located?

Tabitha Cantrell practices at 11624 Jollyville Rd Apt 538, Austin, TX 78759. The listed phone number is (512) 680-5028.

What is Tabitha Cantrell's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is Tabitha Cantrell enrolled in Medicare?

Yes. Tabitha Cantrell is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Tabitha Cantrell was last updated on January 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.