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JESSE ALLAN BOUTWELL PHYSICIAN ASSISTANT
NPI 1912977117
Physician Assistant - Medical in Bandera, TX

Active since January 23, 2006PECOS EnrolledAccepts Medicare Assignment
1050 STATE HIGHWAY 16 S, BANDERA, TX 78003(830) 261-0684 Get Directions Write a Review

NPPES record last updated: October 17, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jesse Allan Boutwell Physician Assistant NPPES

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

JESSE ALLAN BOUTWELL PHYSICIAN ASSISTANT (NPI 1912977117) is an individual medical provider in Bandera, Texas, licensed in Texas (PA00055) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1912977117
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameJESSE ALLAN BOUTWELLCredential: PHYSICIAN ASSISTANT
Location Address1050 STATE HIGHWAY 16 SBandera, TX 78003-4830
Mailing Address1050 State Highway 16 SBandera, TX 78003-4830 · (830) 261-0684
Phone(830) 261-0684
Sole ProprietorNo
Medical School CMSOtherGraduated 2006
Enumeration DateJanuary 23, 2006
Last NPPES UpdateOctober 17, 2016
✔ NPI 1912977117 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in TX · PA00055
1050 STATE HIGHWAY 16 S, Bandera, TX 78003
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Other Identifiers 2

Medicare UPINR59579
OtherZ142263Ptan

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

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

Jesse Allan Boutwell Physician Assistant 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 ID6800708876
PECOS Enrollment IDI20040629001264
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
16 services16 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
16 services16 patients

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JEANNE DIANE THACKER MSN CNS, FNP-C
Nurse Practitioner (Family)
1050 STATE HIGHWAY 16 S
BANDERA, TX 78003
Bandera County (830) 796-7713

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 Jesse Boutwell's NPI number?

The NPI number for Jesse Boutwell is 1912977117. It was assigned to this individual provider in the NPPES registry on January 23, 2006.

Where is Jesse Boutwell located?

Jesse Boutwell practices at 1050 State Highway 16 S, Bandera, TX 78003. The listed phone number is (830) 261-0684.

What is Jesse Boutwell's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Jesse Boutwell enrolled in Medicare?

Yes. Jesse Boutwell 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.

What insurance does Jesse Boutwell accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Jesse Boutwell 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 Jesse Boutwell was last updated on October 17, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.