Michael Roy De Jesus, DNP, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN002635 Issued in NV

Practice address

271 Fort Richardson Ave
Goodfellow AFB, TX 76908-4901

Phone

(325) 654-3149

NPI assigned

Aug 31, 2017

Last updated

Sep 16, 2024By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, NV2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Texas Tech University Health Sciences Center El Paso

  • Internal Medicine Physician
  • El Paso, TX
  • NPI 1598705055
  Medicare reassignment NPD
• Nevada Acute Medical Services-Scherr 1 PC

  • Hospitalist Physician
  • Las Vegas, NV
  • NPI 1992244438
  Medicare reassignment NPD
• Texas Tech University Health Sciences Center El Paso

  • Neurological Surgery Physician
  • El Paso, TX
  • NPI 1457913444
  NPD
• Texas Tech University Health Sciences Center El Paso

  • Surgery Physician
  • El Paso, TX
  • NPI 1538240478
  NPD

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1134647035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271 FORT RICHARDSON AVE",
            "city": "GOODFELLOW AFB",
            "state": "TX",
            "postal_code": "769084901",
            "telephone_number": "325-654-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 FORT RICHARDSON AVE",
            "city": "GOODFELLOW AFB",
            "state": "TX",
            "postal_code": "769084901",
            "telephone_number": "325-654-3149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE JESUS",
        "first_name": "MICHAEL ROY",
        "name_prefix": "Mr.",
        "credential": "DNP, APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-31",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP134221",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN002635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William C Chidichimo, LCSW
• Pedro Colon
• Kristen Cooper, LCSW
• Kelly Erin Corbit, M-PAS, PA-C
• Mindy Courter, LCSW
• Andrew Amadeus De Los Reyes, IDMT
• Lindsay Elisha Denton, O.D.
• Warren Dial, PA
• Amanda Michele Durbin, MA
• Sonia B Flick, LCSW-S, MCAP

• Family Nurse Practitioner in Goodfellow AFB, TX
• Providers in Goodfellow AFB, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.