Individual provider Active NPI

Jessica Renee Zacek, CRNA

  • Certified Registered Nurse Anesthetist
  • Houston, TX
National Provider Identifier
1275510091
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP111439 Issued in TX
Practice address
1500 Citywest Blvd Ste 300
Houston, TX 77042-2549
Phone
(972) 715-0000
NPI assigned
Dec 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 633024 TX
Certified Registered Nurse Anesthetist 367500000X AP111439 TX Primary

Addresses

Primary practice location

1500 Citywest Blvd Ste 300
Houston, TX 77042-2549

Mailing address

PO Box 840853
Dallas, TX 75284-0853
Phone (972) 233-1999

Other practice location 1

9301 N Central Expy Ste 685
Dallas, TX 75231-0806
Phone (972) 572-6101

Other practice location 2

800 W Arbrook Blvd Ste 120
Arlington, TX 76015-4316
Phone (817) 468-4343

Other practice location 3

17051 Dallas Pkwy Ste 440
Addison, TX 75001-7114
Phone (972) 572-6101

Other practice location 4

6606 Lbj Fwy Ste 200
Dallas, TX 75240
Phone (972) 715-5000

Other practice location 5

2010 W Katherine P Raines Rd Ste 500
Cleburne, TX 76033-7464
Phone (817) 558-4600

Other practice location 6

5323 Harry Hines Blvd
Dallas, TX 75390
Phone (214) 648-6400

Other identifiers 5

IdentifierTypeStateIssuer
P00265383OtherTXRAILROAD
155266302MedicaidTX
155266304MedicaidTX
155266303MedicaidTX
83362UOtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040427001650 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 3870580327 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
U S Anesthesia Partners of Texas, PAGroup PAC ID 7315850351, 2,750 clinicians

Practice addresses (Care Compare)

9301 N Central Expy
Dallas, TX 75231-0806
Phone (972) 572-6101

Hospital & facility affiliations

  • Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184
  • Texas Orthopedic Hospital Hospital, Houston, TX, CCN 450804

Merit-based Incentive Payment System (MIPS)

Final score
88.94 of 100Reported as group
Quality
91.31
Improvement activities
40
Cost
79.05

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
633024TXMDCertified Registered Nurse Anesthetist
AP111439TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2019 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Apr 1, 2019 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients

Locations

4343 N Josey Ln
Carrollton, TX 75010
Phone (972) 394-2280

6201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 633-4700

701 Tuscan Dr
Ste 100
Irving, TX 75039
Phone (214) 496-1100

4500 Medical Center Dr
McKinney, TX 75069
Phone (972) 547-8190

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1275510091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840853",
            "telephone_number": "972-233-1999",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CITYWEST BLVD STE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770422549",
            "telephone_number": "972-715-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9301 N Central Expy Ste 685",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752310806",
            "country_code": "US",
            "telephone_number": "972-572-6101",
            "fax_number": "972-572-6104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 W Arbrook Blvd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760154316",
            "country_code": "US",
            "telephone_number": "817-468-4343",
            "fax_number": "817-468-3438",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17051 Dallas Pkwy Ste 440",
            "address_purpose": "LOCATION",
            "city": "Addison",
            "state": "TX",
            "postal_code": "750017114",
            "country_code": "US",
            "telephone_number": "972-572-6101",
            "fax_number": "972-572-6104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6606 Lbj Fwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "75240",
            "country_code": "US",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2010 W Katherine P Raines Rd Ste 500",
            "address_purpose": "LOCATION",
            "city": "Cleburne",
            "state": "TX",
            "postal_code": "760337464",
            "country_code": "US",
            "telephone_number": "817-558-4600",
            "fax_number": "817-558-4602",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5323 Harry Hines Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "75390",
            "country_code": "US",
            "telephone_number": "214-648-6400",
            "fax_number": "214-648-5461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZACEK",
        "first_name": "JESSICA",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "633024",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP111439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00265383",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155266302",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155266304",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155266303",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "83362U",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.