Individual provider Active NPI

Jennifer Ann Pak, D.O.

  • Family Medicine Physician
  • Cypress, TX
National Provider Identifier
1053549527
Registry record updated Aug 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N8005 Issued in TX
Practice address
9915 Barker Cypress Rd Ste 200
Cypress, TX 77433-1260
Phone
(281) 737-1555
Fax
(281) 737-1556
NPI assigned
Jun 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X N8005 TX Primary

Addresses

Primary practice location

9915 Barker Cypress Rd Ste 200
Cypress, TX 77433-1260

Mailing address

9915 Barker Cypress Rd Ste 200
Cypress, TX 77433-1260
Phone (281) 737-1555

Other practice location 1

1500 S Dairy Ashford Rd
Ste 198
Houston, TX 77077-3854
Phone (281) 759-0200

Other names 1

  • Jennifer Ann Farrell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110420000229 TX Practitioner - Family Practice 5890970776 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Texas HSC, College of Osteopathic Med, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
TMH Physician Associates PLLCGroup PAC ID 4486711744, 1,881 clinicians

Practice addresses (Care Compare)

4710 Bellaire Blvd
Bellaire, TX 77401-4505
Phone (713) 363-9411

7550 Greenbriar Dr
Houston, TX 77030-4508

7575 San Felipe St
Suite 155
Houston, TX 77063-1777
Phone (713) 266-9955

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
N8005TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wang&Jiang, MD, PA Family Medicine CurrentSince Aug 1, 2012 Accepting new patients
TMH Physician Associates PLLC Family Medicine CurrentSince Sep 7, 2020 Accepting new patients
TMH Physician Associates PLLC CurrentSince Sep 7, 2020 Accepting new patients
Memorial Hermann Health System Family Medicine Past Accepting new patients
Dairy Ashford Family Practice Associates, P.a. PastSince Aug 1, 2012 Accepting new patients
Memorial Hermann Health System Past Accepting new patients

Locations

9915 Barker Cypress Rd
Ste 200
Cypress, TX 77433
Phone (281) 737-0435

7575 San Felipe St
Ste 155
Houston, TX 77063
Phone (713) 266-9955

9999 Bellaire Blvd
Ste 370
Houston, TX 77036
Phone (713) 270-0909

1500 S Dairy Ashford Rd
Ste 198
Houston, TX 77077
Phone (281) 759-0200

2505 S Park Ave
Ste B
Pearland, TX 77581
Phone (281) 485-0334

16605 Southwest Fwy
Ste 400
Sugar Land, TX 77479
Phone (281) 275-0800

Interoperability endpoints

  • Direct secure messaging: jpak342555@directhoustonmethodist.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598140800000",
    "number": "1053549527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9915 BARKER CYPRESS RD STE 200",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774331260",
            "telephone_number": "281-737-1555",
            "fax_number": "281-737-1556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9915 BARKER CYPRESS RD STE 200",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774331260",
            "telephone_number": "281-737-1555",
            "fax_number": "281-737-1556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 S Dairy Ashford Rd",
            "address_2": "Ste 198",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770773854",
            "country_code": "US",
            "telephone_number": "281-759-0200",
            "fax_number": "281-759-4715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAK",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-23",
        "last_updated": "2020-08-23",
        "certification_date": "2020-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N8005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "FARRELL",
            "middle_name": "ANN",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cypress, TX

Sources for this page

Verify at the official NPI Registry.