Individual provider Active NPI

Gary Kimble Jett, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Plano, TX
National Provider Identifier
1184690810
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
F1681 Issued in TX
Practice address
4716 Alliance Blvd
Suite 310
Plano, TX 75093-5371
Phone
(469) 800-6200
Fax
(469) 800-6210
NPI assigned
Feb 23, 2006
Last updated
Jun 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X F1681 TX Primary

Addresses

Primary practice location

4716 Alliance Blvd
Suite 310
Plano, TX 75093-5371

Mailing address

4716 Alliance Blvd
Suite 310
Plano, TX 75093-5371
Phone (469) 800-6200

Other identifiers 1

IdentifierTypeStateIssuer
0178010801MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gjett224891@direct.sw.org

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
I20040629000978 TX Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 1153307830 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince May 4, 2015 Accepting new patients
Healthtexas Provider Network CurrentSince May 4, 2015 Accepting new patients
Healthtexas Provider Network Current Accepting new patients
Midatlantic Cardiovascular Associates PA Thoracic Surgery (Cardiothoracic Vascular Surgery) Past Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (469) 800-8648

4708 Alliance Blvd
Ste 540
Plano, TX 75093
Phone (469) 800-6200

4716 Alliance Blvd
Ste 310
Plano, TX 75093
Phone (469) 800-6200

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

Interoperability endpoints

  • Direct secure messaging: gjett224891@direct.sw.org

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Baylor Scott & White the Heart Hospital - PlanoPlano, TX, CCN 670025 Hospital General Partnership Interest
Corporate Director
Jun 1, 2007
Jun 1, 2007
Baylor Scott & White the Heart Hospital - DentonDenton, TX, CCN 450893 Hospital General Partnership Interest Jun 1, 2007
Baylor Scott & White the Heart Hospital RehabilitationDenton, TX, CCN 67T347 Hospital General Partnership Interest Nov 1, 2024

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1184690810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4716 ALLIANCE BLVD",
            "address_2": "SUITE 310",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935371",
            "telephone_number": "469-800-6200",
            "fax_number": "469-800-6210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4716 ALLIANCE BLVD",
            "address_2": "SUITE 310",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935371",
            "telephone_number": "469-800-6200",
            "fax_number": "469-800-6210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETT",
        "first_name": "GARY",
        "middle_name": "KIMBLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "F1681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0178010801",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gjett224891@direct.sw.org",
            "affiliation": "N",
            "address_1": "4708 Alliance Blvd Ste 540",
            "city": "Plano",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750935339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.