Jill Quiambao, RN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

667190 Issued in TX

Practice address

1220 N Pacific St Ste 2
Mineola, TX 75773-1068

Phone

(903) 569-0610

Fax

(903) 569-0676

NPI assigned

Jan 15, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Texas Health Science Center at Tyler-Facilty-PhysicianGroup PAC ID 4981699220, 118 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Texas Health Science Center at Tyler Hospital, Tyler, TX, CCN 450690
• Ut Health East Texas Athens Hospital Hospital, Athens, TX, CCN 450389
• Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jquiambao354951@ahs.direct-ci.com

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.

• University of Texas Health Science Center at Tyler-Facility-Physician

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Tyler, TX
  • NPI 1063400778
  Medicare reassignment Care Compare group NPD
• University of Texas Health Science Center at Tyler-Facilty-Physician

  dba UT Health East Texas Physicians Overton

  • Rural Health Clinic/Center
  • Overton, TX
  • NPI 1689496812
  NPD
• East Texas Medical Center Quitman

  dba ETMC First Physicians Clinic Mineola 2

  • Rural Health Clinic/Center
  • Mineola, TX
  • NPI 1639184369
  NPD (past)

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

• Athens Hospital, LLC

  • General Acute Care Hospital
  • Athens, TX
  • NPI 1417465824
  Care Compare affiliation
• Mother Frances Hospital Regional Health Care Center

  dba Christus Mother Frances Hospital Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Care Compare affiliation
• Tyler Regional Hospital LLC

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1407364847
  Care Compare affiliation
• University of Texas Health Science Center at Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1417941295
  Care Compare affiliation

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265583504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 N PACIFIC ST STE 2",
            "city": "MINEOLA",
            "state": "TX",
            "postal_code": "757731068",
            "telephone_number": "903-569-0610",
            "fax_number": "903-569-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 N PACIFIC ST STE 2",
            "city": "MINEOLA",
            "state": "TX",
            "postal_code": "757731068",
            "telephone_number": "903-569-0610",
            "fax_number": "903-569-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIAMBAO",
        "first_name": "JILL",
        "credential": "RN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "667190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC #",
            "identifier": "667190",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Paden Overbey
• Jadi Donn Parker, PHARM. D.
• Kokeesha E. Paul, FNP
• Tony Phillips, PA
• Pillans Healthcare (Community Care Center of Mineola)
• Quitman Hospital LLC
• RCG East Texas, LLP (Renal Care Group Mineola)
• Mindy Ann Redding, LPC
• Melissa Anne Reuvers
• Hollie Rhodes, ABOC

• Family Nurse Practitioner in Mineola, TX
• Providers in Mineola, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• 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.