BLUE AGAVE FUNCTIONAL MEDICINE BOERNE PLLC
NPI 1235096447
General Practice in Boerne, TX

Active since January 08, 2026
5 COUGHRAN RD STE 101, BOERNE, TX 78006(830) 491-4040(833) 468-4963 Get Directions Write a Review

NPPES record last updated: August 13, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 13, 2026, Jan 8, 2026 (2 updates tracked since 2026).

About Blue Agave Functional Medicine Boerne Pllc NPPES

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

BLUE AGAVE FUNCTIONAL MEDICINE BOERNE PLLC (NPI 1235096447), doing business as Blue Agave Functional Medicine Clinic, is a healthcare organization registered as a general practice in Boerne, Texas and active in the NPI registry since January 2026. The organization lists Scott P Knepper, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1235096447
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameBLUE AGAVE FUNCTIONAL MEDICINE BOERNE PLLC
Location Address5 COUGHRAN RD STE 101Boerne, TX 78006-8103
Mailing Address5 Coughran Rd # 101Boerne, TX 78006-8103 · (830) 491-4040 · Fax (833) 468-4963
Fax(833) 468-4963
Organization SubpartNo
Authorized OfficialScott P KnepperMedical Director · (512) 293-9800
Enumeration DateJanuary 8, 2026
Last NPPES UpdateAugust 13, 20262 updates tracked since enumeration
NPPES CertifiedAugust 13, 2026
✔ NPI 1235096447 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
5 COUGHRAN RD STE 101, Boerne, TX 78006

Other Names 1

Doing Business AsBlue Agave Functional Medicine Clinic

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Blue Agave Functional Medicine Boerne Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Blue Agave Functional Medicine Boerne PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

General Practice
NPI 1013353747
651 S BUSINESS IH 35 STE 730
New Braunfels, TX 78130
(830) 491-4040
✔ PECOS✔ Accepts Medicare38 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Blue Agave Functional Medicine Boerne PLLC's NPI number?

The NPI number for Blue Agave Functional Medicine Boerne PLLC is 1235096447. It was assigned to this organization in the NPPES registry on January 8, 2026. The provider is doing business as Blue Agave Functional Medicine Clinic.

Where is Blue Agave Functional Medicine Boerne PLLC located?

Blue Agave Functional Medicine Boerne PLLC is located at 5 Coughran Rd Ste 101, Boerne, TX 78006. The listed phone number is (830) 491-4040.

What is Blue Agave Functional Medicine Boerne PLLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Blue Agave Functional Medicine Boerne PLLC enrolled in Medicare?

Yes. Blue Agave Functional Medicine Boerne PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Blue Agave Functional Medicine Boerne PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (General Practice) reassigns their Medicare billing to Blue Agave Functional Medicine Boerne PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Blue Agave Functional Medicine Boerne PLLC accept?

Health plans from Blue Cross and Blue Shield of Texas list Blue Agave Functional Medicine Boerne PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Blue Agave Functional Medicine Boerne PLLC was last updated on August 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.