Active NPI
Jennifer Lynn Pomales, PA
- Physician Assistant
- Wylie, TX
National Provider Identifier
1285881755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA05874
- Practice address
- 704 Riverhead Dr
Wylie, TX 75098-8735 - Phone
- (214) 641-5787
- NPI assigned
- Aug 26, 2008
- Last updated
- Jan 8, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA05874 | TX | Primary |
Addresses
Primary practice location
704 Riverhead Dr
Wylie, TX 75098-8735
Mailing address
704 Riverhead Dr
Wylie, TX 75098-8735
Phone (214) 641-5787
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 197786001 | Medicaid | TX | |
| 197786003 | Medicaid | TX | |
| 197786002 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Texas Inpatient and Geriatric Associates PA | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba NTIGA Infusion
- Home Infusion Therapy Pharmacy
- Dallas, TX
- NPI 1104020494
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262908800000",
"number": "1285881755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "704 RIVERHEAD DR",
"city": "WYLIE",
"state": "TX",
"postal_code": "750988735",
"telephone_number": "214-641-5787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "704 RIVERHEAD DR",
"city": "WYLIE",
"state": "TX",
"postal_code": "750988735",
"telephone_number": "214-641-5787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POMALES",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-26",
"last_updated": "2010-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA05874",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "197786001",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "197786003",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "197786002",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wylie, TX
- Daralyn A. Plains, PH.D.
- Plano Children's Medical Clinic
- Podiatric Medical Partners of Texas, PA (Wylie Foot Ankle Specialist)
- Pointe' Homehealth Corporation
- Randy Harold Points, LPC ASSOCIATE
- Tydesheaia Ladejenee Pool
- Precious Home Health
- Premier Medical Associates of North Texas PLLC
- Prestige Evaluation and Consulting Services, LLC
- Beverly Faith Price, LMSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2010; 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.