Jacob T Stephenson, MD

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

U5819 Issued in TX

Practice address

1102 Bates Ave # Fc1440
Houston, TX 77030-2698

Phone

(832) 828-3660

NPI assigned

Jan 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jstephenson483788@prddirect.texaschildrens.org

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.

• Baylor College of Medicine

  • Pediatrics Physician
  • San Antonio, TX
  • NPI 1285079764
  Medicare reassignment NPD
• Texas Children'S Physician Group

  • Pediatrics Physician
  • Houston, TX
  • NPI 1861675506
  Medicare reassignment NPD
• Texas Children'S Hospital

  • Children's Hospital
  • Austin, TX
  • NPI 1194507947
  NPD (past)
• Shriners Hospitals for Children

  • Orthopaedic Surgery Physician
  • Lexington, KY
  • NPI 1700223559
  NPD (past)

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704585600000",
    "number": "1265411979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 BATES AVE # FC1440",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302698",
            "telephone_number": "832-828-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 BATES AVE # FC1440",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302698",
            "telephone_number": "832-828-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "JACOB",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2024-01-07",
        "certification_date": "2024-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "U5819",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "CA",
            "license": "92264",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "TX",
            "license": "U5819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Toni Stephens
• Trish Nguyen Stephens, M.D.
• Yehkyoung C Stephens, PA-C
• Carol Ann Stephenson, DNP, RN, NP-C
• Donna Marie Stephenson, APRN
• Kittredge Stephenson, PH.D.
• Lillian Stephenson
• Melissa Stephenson
• Todd Adam Stephenson, LSA
• Stepmedics Physical Health

• Pediatric Surgery Physician in Houston, TX
• Providers in Houston, TX by specialty
• Pediatric Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.