DR. JACLYN ANN BOOZALIS MD
NPI 1922620418
Internal Medicine in Austin, TX

Q: What is Jaclyn Boozalis's NPI number?

The NPI number for Jaclyn Boozalis is 1922620418. It was assigned to this individual provider in the NPPES registry on May 7, 2020.

Q: What is Jaclyn Boozalis's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Jaclyn Boozalis was last updated on September 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since May 07, 2020PECOS EnrolledAccepts Medicare Assignment

1108 LAVACA ST STE 110-320, AUSTIN, TX 78701(512) 477-4088(512) 482-0390 Get Directions Write a Review

NPPES record last updated: September 5, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 5, 2025, Jul 1, 2024, Jun 26, 2024 and 1 more (4 updates tracked since 2020).

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About Dr. Jaclyn Ann Boozalis Md NPPES

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

DR. JACLYN ANN BOOZALIS MD (NPI 1922620418) is an individual internal medicine provider in Austin, Texas, licensed in Texas (U2442) and active in the NPI registry since May 2020. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of University Of Texas Medical School At San Antonio (2020).

NPPES Registry Identity

NPI1922620418

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameDR. JACLYN ANN BOOZALISCredential: MD

Location Address1108 LAVACA ST STE 110-320Austin, TX 78701-2172

Mailing Address1108 Lavaca St Ste 110-320Austin, TX 78701-2172 · (512) 477-4088 · Fax (512) 482-0390

Phone(512) 477-4088

Fax(512) 482-0390

Sole ProprietorNo

Medical School CMSUniversity Of Texas Medical School At San AntonioGraduated 2020

Enumeration DateMay 7, 2020

Last NPPES UpdateSeptember 5, 20254 updates tracked since enumeration

NPPES CertifiedSeptember 5, 2025

✔ NPI 1922620418 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Licenses✔ Licensed in TX · U2442✔ Licensed in RI · MD19826

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedInternal Medicine · Hospice and Palliative MedicineTaxonomy 207RH0002X · License U2442 (TX)

1108 LAVACA ST STE 110-320, Austin, TX 78701

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Secondary Practice Locations 2

Location 11500 Red River, Dell Seton Medical CenterAustin, TX 78701 · Phone (361) 649-6663

Location 2593 Eddy StProvidence, RI 02903-4923 · Phone (401) 444-4000

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

Dr. Jaclyn Ann Boozalis Md 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 ID4981136298

PECOS Enrollment IDI20250909003356

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 78701 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

$131.95 typical visit price

range $57.88 – $174.00

Typical copayment $32.98 (range $14.47 – $43.50)

Most-billed visit code 99204

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.

Other Providers at the Same Location NPPES 20

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

OSCAR MISAEL PADRON AGNP-C

Nurse Practitioner (Gerontology)