Organization Active NPI

Crescent Direct Primary Care PLLC

  • Family Medicine Physician
  • Trophy Club, TX
National Provider Identifier
1124979950
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CRESCENT DIRECT PRIMARY CARE PLLC
Practice address
2800 E Highway 114 Ste 200
Trophy Club, TX 76262-5306
Phone
(682) 800-4727
NPI assigned
Feb 6, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2026

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

Authorized official

Name
Dr. Elvira Jasarevic, DONPI 1295199677
Title
Physician
Phone
(336) 207-5677

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: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2800 E Highway 114 Ste 200
Trophy Club, TX 76262-5306

Mailing address

23 Durango Dr
Trophy Club, TX 76262-5120

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260529001178 TX Part B Supplier - Clinic/Group Practice 6204306350 Receives reassigned benefits from 1 practitioner
Practice locations: Trophy Club, TX

National Provider Directory

National Provider Directory

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": "1770336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772582400000",
    "number": "1124979950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 DURANGO DR",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "762625120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E HIGHWAY 114 STE 200",
            "city": "TROPHY CLUB",
            "state": "TX",
            "postal_code": "762625306",
            "telephone_number": "682-800-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT DIRECT PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-06",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A",
        "authorized_official_last_name": "JASAREVIC",
        "authorized_official_first_name": "ELVIRA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "336-207-5677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trophy Club, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.