Individual provider Active NPI

Tiffany L. Johnson, ACNP-BC

  • Acute Care Nurse Practitioner
  • Pasadena, TX
National Provider Identifier
1235389107
Registry record updated Sep 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
676193 Issued in TX
Practice address
4102 Woodlawn Ave
Suite 110
Pasadena, TX 77504-1947
Phone
(713) 946-6081
NPI assigned
Sep 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 676193 TX Primary

Addresses

Primary practice location

4102 Woodlawn Ave
Suite 110
Pasadena, TX 77504-1947

Mailing address

4102 Woodlawn Ave
Suite 110
Pasadena, TX 77504
Phone (713) 946-6081

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
I20151023000472 TX Practitioner - Nurse Practitioner 3870802341 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

6400 Fannin St
Suite 2700
Houston, TX 77030-1539
Phone (713) 486-5000

6410 Fannin St
Houston, TX 77030-3005

6411 Fannin St
Houston, TX 77030-1501
Phone (713) 704-0093

6431 Fannin St
MSB2.100
Houston, TX 77030-1501
Phone (713) 500-7700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
676193TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Aug 31, 2015 Accepting new patients
Ut Physicians CurrentSince Aug 31, 2015 Accepting new patients

Locations

6431 Fannin St
Ste 5020
Houston, TX 77030
Phone (713) 500-6200

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

Interoperability endpoints

  • Direct secure messaging: tjohnson42553@memorialhermann.direct-ci.com

Organizations & group practices 2

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 2

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": "1222387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222387200000",
    "number": "1235389107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 WOODLAWN AVE",
            "address_2": "SUITE 110",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "77504",
            "telephone_number": "713-946-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 WOODLAWN AVE",
            "address_2": "SUITE 110",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775041947",
            "telephone_number": "713-946-6081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TIFFANY",
        "middle_name": "L.",
        "credential": "ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-26",
        "last_updated": "2008-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "676193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

Verify at the official NPI Registry.