Individual provider Active NPI

Paul Jew, MD

  • Family Medicine Physician
  • Amarillo, TX
National Provider Identifier
1114086253
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G5219 Issued in TX
Practice address
1801 A Halstead
Amarillo, TX 79106
Phone
(806) 351-1530
Fax
(806) 331-1751
NPI assigned
Dec 6, 2006
Last updated
Jul 2, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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 G5219 TX Primary

Addresses

Primary practice location

1801 A Halstead
Amarillo, TX 79106

Mailing address

1801 A Halstead
Amarillo, TX 79106
Phone (806) 351-1530

Other identifiers 2

IdentifierTypeStateIssuer
00L21KOtherTXBCBS
135639602MedicaidTX

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
I20031205000147 TX Practitioner - Family Practice 2062317670 Reassigns benefits to 1 organization
Practice locations: Amarillo, TX

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas Tech University Health Science Center School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Act Physician Group, PAGroup PAC ID 8729261623, 6 clinicians

Practice addresses (Care Compare)

3440 Bell St
Unit 122
Amarillo, TX 79109-4100
Phone (806) 379-9225

Hospital & facility affiliations

National Provider Directory

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

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1114086253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 A HALSTEAD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "79106",
            "telephone_number": "806-351-1530",
            "fax_number": "806-331-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 A HALSTEAD",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "79106",
            "telephone_number": "806-351-1530",
            "fax_number": "806-331-1751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEW",
        "first_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G5219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00L21K",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135639602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.