Individual provider Active NPI

Jill Jaimes, MD

  • Emergency Medicine Physician
  • Houston, TX
National Provider Identifier
1265512529
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
L6437 Issued in TX
Practice address
6621 Fannin St
Houston, TX 77030-2303
Phone
(832) 824-5497
Fax
(832) 825-5424
NPI assigned
Oct 17, 2006
Last updated
Nov 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X L6437 TX Primary
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X L6437 TX

Addresses

Primary practice location

6621 Fannin St
Houston, TX 77030-2303

Mailing address

6621 Fannin St
Houston, TX 77030-2303
Phone (832) 824-5497

Other identifiers 1

IdentifierTypeStateIssuer
159594401MedicaidTX

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
I20031106000173 TX Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 6406769553 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L6437TXMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Longhorn Emergency Medical Associates PA Emergency Medicine CurrentSince Dec 15, 2019 Accepting new patients
Texas Children's Physician Group CurrentSince Apr 16, 2024 Accepting new patients
Baylor College of Medicine Past Accepting new patients

Locations

8611 N Mopac Expy
Austin, TX 78759
Phone (713) 816-1250

919 E 32nd St
Austin, TX 78705
Phone (512) 343-2466

6621 Fannin St
Houston, TX 77030
Phone (832) 824-1866

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1265512529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302303",
            "telephone_number": "832-824-5497",
            "fax_number": "832-825-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302303",
            "telephone_number": "832-824-5497",
            "fax_number": "832-825-5424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIMES",
        "first_name": "JILL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "L6437",
            "primary": true
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "TX",
            "license": "L6437",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159594401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.