Individual provider Active NPI

Jillian Clesi, PA-C

  • Physician Assistant
  • Humble, TX
National Provider Identifier
1215438692
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2905 Issued in SC
Practice address
7072 FM 1960 Rd E Ste 7
Humble, TX 77346-2788
Phone
(281) 397-5258
NPI assigned
Feb 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2905 SC Primary

Addresses

Primary practice location

7072 FM 1960 Rd E Ste 7
Humble, TX 77346-2788

Mailing address

7072 FM 1960 Rd E Ste 7
Humble, TX 77346-2788
Phone (281) 397-5258

Other identifiers 1

IdentifierTypeStateIssuer
3618PAMedicaidSC

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220128001145 TX Practitioner - Physician Assistant 5890050421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Houston Carenow Urgent Care PLLCGroup PAC ID 7012291958, 113 clinicians

Practice addresses (Care Compare)

10422 Research Forest Dr
Magnolia, TX 77354-6155
Phone (832) 702-7699

300 Northpark Dr
Kingwood, TX 77339-1672
Phone (281) 310-8445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1215438692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7072 FM 1960 RD E STE 7",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773462788",
            "telephone_number": "281-397-5258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7072 FM 1960 RD E STE 7",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773462788",
            "telephone_number": "281-397-5258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLESI",
        "first_name": "JILLIAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-22",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3618PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Humble, TX

Sources for this page

Verify at the official NPI Registry.