NINA JOLLEY (PA-C) – Physician Assistant, NPI 1023684669

NINA JOLLEY (PA-C) is a healthcare provider. based in Austin, Texas. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA14615 (TX). The NPI Number for NINA JOLLEY (PA-C) is 1023684669

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
NINA JOLLEY (PA-C)
NPI
1023684669
Phone
Not provided
Address
1114 LOST CREEK BLVD STE 110
Enumeration Date
3 June 2021
Last Update Date
6 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5124518211
Graduation Year
2020 (6 years ago)
PAC ID
0446697411
Group Practice PAC ID
6103079462
Professional Enrollment ID
I20240326002700
Address ID
TX787585614AU12200WAYX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness85
Years active:5State licenses:1Digital endpointsOther names

8,491 PHYSICIAN ASSISTANT in TX

Provider Addresses for NINA JOLLEY (PA-C)

  • 1114 LOST CREEK BLVD STE 110

    AUSTIN, TX 787466676

    Phone:

    Type: Mailing

  • 12200 RENFERT WAY STE 100

    AUSTIN, TX 787585654

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 37 Open Payments records for all available years, with a total value of $2,227.

Total Amount is formed as General ($2,227) + Research ($0) + Ownership ($0) = $2,227.

Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Medtronic, Inc. ($310).

Total Amount

$2,227

General + Research + Ownership

Payments

37

Total payment records

General Amount

$2,227

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-19

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-03-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240326002700IPhysician AssistantTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 78746)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6103079462View full group profile
NameSpecialtyState
Nurse PractitionerTX
O B S T E T R I C S/ G Y N E C O L O G YTX
Nurse PractitionerTX
Nurse PractitionerTX
Physician AssistantTX
O B S T E T R I C S/ G Y N E C O L O G YTX
Nurse PractitionerTX
Nurse PractitionerGA
O B S T E T R I C S/ G Y N E C O L O G YTX
-TX

Reviews

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Frequently asked questions

What identifier follows NINA JOLLEY (PA-C) across health systems?
The NPI 1023684669 uniquely identifies NINA JOLLEY (PA-C) in U.S. healthcare data.
Is NINA JOLLEY (PA-C)'s NPI status active today?
Active status means NINA JOLLEY (PA-C)'s NPI record is not deactivated in the public file.
What services align with NINA JOLLEY (PA-C)'s listing?
NINA JOLLEY (PA-C)'s public classification highlights Physician Assistant. Clinical services aligned with this taxonomy classification.
What geographic area is tied to NINA JOLLEY (PA-C)?
NINA JOLLEY (PA-C) is associated with Austin, Texas in the same public data insurers reference.
Who maintains NINA JOLLEY (PA-C)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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