Jacob Ethridge, PA
NPI 1104301852 · Physician Assistant · San Antonio, TX
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jacob Ethridge, PA is a Physician Assistant provider in San Antonio, TX (NPI 1104301852).
Provider details
- NPI number
- 1104301852
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- License
- TEMPORARY (TX)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure33% of score
8 yrs in NPPES registry
- Profile completeness33% of score
100% of core fields populated
- Practice footprint20% of score
3 documented practice locations
- Open Payments transparency13% of score
Has Open Payments disclosures (2024)
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$17 across 1 record (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Additional practice locations (2)
- 10423 State Highway 151 Ste 101San Antonio, TX 78251-4768Phone: (210) 341-9614
- 5282 Medical Dr Ste 250San Antonio, TX 78229-6039Phone: (210) 341-9614
Registry dates
- Enumerated
- 2018-09-28
- Last updated
- 2022-06-29
- Certified
- 2022-06-29
Frequently asked questions
- What is Jacob Ethridge's NPI number?
- Jacob Ethridge's National Provider Identifier (NPI) is 1104301852, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jacob Ethridge's specialty?
- Jacob Ethridge is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Jacob Ethridge located?
- Jacob Ethridge's practice location on file with NPPES is 1150 N Loop 1604 W Ste 150, San Antonio, TX 78248-4505.
- What is Jacob Ethridge's phone number?
- The practice phone number listed in the NPPES registry for Jacob Ethridge is (281) 783-8162.
- Does Jacob Ethridge accept Medicare?
- Jacob Ethridge is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Jacob Ethridge's NPI active?
- Yes — Jacob Ethridge's NPI (1104301852) is active in the NPPES registry as of the last update on 2022-06-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.