Jared Blaine Mabery, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

K7809 Issued in TX

Practice address

2400 Round Rock Ave
Round Rock, TX 78681-4004

Phone

(512) 341-1000

NPI assigned

May 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Specialty

Emergency Medicine

Education

Texas a & M University System, HSC, College of Medicine, 1998

Medicare assignment

May accept Medicare assignment

Group practices

Century Integrated Partners, IncGroup PAC ID 6406151703, 330 clinicians

Legacy Urgent Care PAGroup PAC ID 3072679828, 157 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott and White Surgical Hospital Fortworth Hospital, Fort Worth, TX, CCN 450880

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Century Integrated Partners, Inc

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1447615711
  Medicare reassignment Care Compare group NPD
• Legacy Urgent Care, PA

  • Urgent Care Clinic/Center
  • Frisco, TX
  • NPI 1568622272
  Medicare reassignment Care Compare group NPD
• Premier Physicians-II, P.a.

  dba Premier Urgent Care Plus

  • Urgent Care Clinic/Center
  • Woodway, TX
  • NPI 1801204656
  Medicare reassignment NPD
• Frisco Emergency Medicine Associates, PA

  • Emergency Care Clinic/Center
  • Frisco, TX
  • NPI 1467612176

  Emergency Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fort Worth Surgicare Partners LTD

  dba Baylor Surgical Hospital at Fort Worth Outpatient Center

  • Special Hospital
  • Fort Worth, TX
  • NPI 1568883775
  Care Compare affiliation
• Fort Worth Surgicare Partners, LTD.

  dba Baylor Scott & White Surgical Hospital - Fort Worth

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1871599183
  Care Compare affiliation

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321833600000",
    "number": "1205884202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5107 WATERFORD CT",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765027317",
            "telephone_number": "254-742-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 ROUND ROCK AVE",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814004",
            "telephone_number": "512-341-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABERY",
        "first_name": "JARED",
        "middle_name": "BLAINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2011-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "K7809",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "K7809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122080805",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122080807",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00967092",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marshall Lyles, MA, LPC, LMFT
• Maria C Lynes, MD
• Andrea Lyon, LCDC
• M Sylvester Gonzales DDS PA
• Misti Brown Maag
• Nadria Shola Mabry
• Kenneth Charles Macaluso, DDS
• Darlene Macauley
• Eileen Minerva Macias-Mendoza, MA, BCBA, LBA
• Megan Mack, D.O.

• Emergency Medicine Physician in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Emergency Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.