Jean Nerva Dortilus, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

P4438 Issued in TX

Practice address

3500 Hillcrest Dr Ste 7
Waco, TX 76708-3144

Phone

(254) 424-9523

NPI assigned

Jan 5, 2009

Last updated

May 27, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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

Specialty

Psychiatry

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Amd Medical PLLCGroup PAC ID 6305170986, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Amd Medical PLLC

  • Psychiatry Physician
  • Waco, TX
  • NPI 1235797994

  Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1231113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558915200000",
    "number": "1063658524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 HILLCREST DR STE 7",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767083144",
            "telephone_number": "254-424-9523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 HILLCREST DR STE 7",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767083144",
            "telephone_number": "254-424-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORTILUS",
        "first_name": "JEAN",
        "middle_name": "NERVA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-05",
        "last_updated": "2019-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "P4438",
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "P4438",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "P4438",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Crain Donoso, FNP-C
• David P Dooley, M.D.
• John Henry Doran, MSW
• Susan A Dornbusch, NP-C
• Jasmine Dorsey
• Tykeyah Dory
• Andrea Dossey
• Garry Dossey
• Nina Maria Dowden, PT
• Ethel Pearl Dowuona, RN

• Psychiatry Physician in Waco, TX
• Providers in Waco, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.