JESSE ALLAN BOUTWELL (PHYSICIAN ASSISTANT) – Medical Physician Assistant, NPI 1912977117
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,491 PHYSICIAN ASSISTANT in TX
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Provider Addresses for JESSE ALLAN BOUTWELL (PHYSICIAN ASSISTANT)
Bandera Family Practice Clinic, 1050, State Highway 16 South, Bandera, Texas, 78003, United States
BANDERA, TX 780034830
Phone: (830) 261-0684
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $69.
Total Amount is formed as General ($69) + Research ($0) + Ownership ($0) = $69.
Last reported payment date: 2024-09-26 • Largest payer in this snapshot: Smith+Nephew, Inc. ($69).
Total Amount
$69
General + Research + Ownership
Payments
1
Total payment records
General Amount
$69
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-26
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Smith+Nephew, Inc. | $69 |
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: 2004-06-29
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040629001264 | I | Physician Assistant | TX | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 50 | 48 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 29 | 29 | $0 |
| 81002 | Urinalysis, manual test | 17 | 17 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 15 | 11 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 12 | 12 | $0 |
Insurance plans in this area (ZIP 78003)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | TX | 81002 | Urinalysis, manual test | 79 | 49 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | TX | |
| Physician Assistant | TX | |
| - | TX | |
| Physician Assistant | IN | |
| Physician Assistant | TX | |
| Physician Assistant | KY |
Reviews
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