Individual provider Active NPI

Jennifer Variste, M.D.

  • Pediatrics Physician
  • College Station, TX
National Provider Identifier
1255687042
Registry record updated Sep 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
P8822 Issued in TX
Practice address
1651 Rock Prairie Rd
Suite 102
College Station, TX 77845-8652
Phone
(979) 693-7400
Fax
(979) 693-7446
NPI assigned
Jul 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X P8822 TX Primary

Addresses

Primary practice location

1651 Rock Prairie Rd
Suite 102
College Station, TX 77845-8652

Mailing address

1500 University Dr E Ste 100
College Station, TX 77840-2600
Phone (979) 846-1100

Other identifiers 3

IdentifierTypeStateIssuer
67-1861OtherTXMEDICARE FACILITY NUMBER
1275726853OtherTXFACILITY NPI
1878423-01OtherTXFACILITY TPI

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
I20140822002427 TX Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 8426276031

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
TCH Pediatric Associates, Inc Pediatrics Past Accepting new patients
TCH Pediatric Associates, Inc Pediatrics Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410134400000",
    "number": "1255687042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 UNIVERSITY DR E STE 100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778402600",
            "telephone_number": "979-846-1100",
            "fax_number": "979-260-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 ROCK PRAIRIE RD",
            "address_2": "SUITE 102",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458652",
            "telephone_number": "979-693-7400",
            "fax_number": "979-693-7446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARISTE",
        "first_name": "JENNIFER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-30",
        "last_updated": "2014-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "P8822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE FACILITY NUMBER",
            "identifier": "67-1861",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY NPI",
            "identifier": "1275726853",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY TPI",
            "identifier": "1878423-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in College Station, TX

Sources for this page

Verify at the official NPI Registry.