Organization Active NPI

JSM Medical Group PLLC

  • Adult Medicine Physician
  • Frisco, TX
National Provider Identifier
1104683457
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
JSM MEDICAL GROUP PLLC
Practice address
5454 Surrey Path Ste 201
Frisco, TX 75034-9582
Phone
(469) 200-0117
Fax
(469) 960-2909
NPI assigned
Mar 4, 2024
Last updated
Mar 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Authorized official

Name
Michelle Marchese
Title
Credentialing Manager
Phone
(214) 205-4995

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X NU Primary

Addresses

Primary practice location

5454 Surrey Path Ste 201
Frisco, TX 75034-9582

Mailing address

5454 Surrey Path Ste 201
Frisco, TX 75034-9582

National Provider Directory

National Provider Directory

Locations

2510 S Brentwood Blvd
Ste 202
Saint Louis, MO 63144
Phone (314) 546-6401

6136 Frisco Square Blvd
Ste 427
Frisco, TX 75034
Phone (469) 356-2734

3300 Dallas Pkwy
Plano, TX 75093
Phone (214) 949-8100

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1104683457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5454 SURREY PATH STE 201",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750349582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5454 SURREY PATH STE 201",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750349582",
            "telephone_number": "469-200-0117",
            "fax_number": "469-960-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JSM MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "MARCHESE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "214-205-4995"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.