Organization Active NPI

JW Family Medicine, PLLC

  • Family Medicine Physician
  • Fulshear, TX
National Provider Identifier
1013550847
Registry record updated Oct 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JW FAMILY MEDICINE, PLLC
Practice address
6230 FM 1463
Suite 800
Fulshear, TX 77441
Phone
(281) 630-8585
NPI assigned
Oct 24, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jose William Aguirre, MDNPI 1205086311
Title
Manager
Phone
(914) 815-3226

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

6230 FM 1463
Suite 800
Fulshear, TX 77441

Mailing address

21302 Plum Gate CT
Richmond, TX 77407-1425
Phone (914) 815-3226

Other names 1

  • JW Family Medicine Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200309002158 TX Part B Supplier - Clinic/Group Practice 8628406410 Receives reassigned benefits from 1 practitioner
Practice locations: Fulshear, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2186889JW Family Medicine6230 FM 1463 Road, Fulshear, TX 77441Certificate of waiverJun 22, 2028

National Provider Directory

National Provider Directory

Locations

6230 FM 1463 Rd
Ste 800
Fulshear, TX 77494
Phone (281) 630-8585

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20332/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571875200000",
    "number": "1013550847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21302 PLUM GATE CT",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774071425",
            "telephone_number": "914-815-3226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6230 FM 1463",
            "address_2": "SUITE 800",
            "city": "FULSHEAR",
            "state": "TX",
            "postal_code": "77441",
            "telephone_number": "281-630-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JW FAMILY MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-24",
        "last_updated": "2019-10-24",
        "status": "A",
        "authorized_official_last_name": "AGUIRRE",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "914-815-3226",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JW Family Medicine",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "JW Family Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fulshear, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.