Individual provider Active NPI

Jeffrey Mansfield-Walker

  • Anesthesiologist Assistant
  • Conroe, TX
National Provider Identifier
1225710486
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
Practice address
504 Medical Center Blvd
Conroe, TX 77304-2808
Phone
(936) 539-1111
NPI assigned
Aug 7, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X TX Primary

Addresses

Primary practice location

504 Medical Center Blvd
Conroe, TX 77304-2808

Mailing address

3121 Buffalo Speedway Apt 8302
Houston, TX 77098-1840
Phone (281) 796-6606

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230908002622 TX Practitioner - Anesthesiology Assistant 9931563921 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Tech University Health Sciences Center LubbockGroup PAC ID 4385549674, 363 clinicians

Practice addresses (Care Compare)

3601 4TH St
Lubbock, TX 79430-9410
Phone (806) 743-3150

Hospital & facility affiliations

  • University Medical Center Hospital, Lubbock, TX, CCN 450686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts, Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Dec 1, 2024 Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Dec 1, 2024 Accepting new patients
Independent Physicians Network PLLC CurrentSince Sep 1, 2023 Accepting new patients
Pediatric Dentistry of Keller PLLC PastSince Jul 28, 2019 Accepting new patients

Locations

504 Medical Center Blvd
Conroe, TX 77304
Phone (936) 539-1111

3300 Oak Lawn Ave
Ste 200
Dallas, TX 75219
Phone (214) 252-3500

3625 N Hall St
Ste 800
Dallas, TX 75219
Phone (214) 252-3500

5858 Westheimer Rd
Ste 82
Houston, TX 77057
Phone (713) 784-6065

3800 N Shepherd Dr
Ste B
Houston, TX 77018
Phone (832) 331-2969

1627 Keller Pkwy
Ste 100
Keller, TX 76248
Phone (480) 207-9709

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

6200 W Parker Rd
Plano, TX 75093
Phone (972) 608-8000

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1225710486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 BUFFALO SPEEDWAY APT 8302",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770981840",
            "telephone_number": "281-796-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 MEDICAL CENTER BLVD",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042808",
            "telephone_number": "936-539-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSFIELD-WALKER",
        "first_name": "JEFFREY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.