Jack Edward Jensen, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

F1071 Issued in TX

Practice address

9180 Katy Fwy Suite 200
Houston, TX 77055-7454

Phone

(713) 984-1400

Fax

(713) 984-0544

NPI assigned

Jul 13, 2005

Sex

Male

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 3

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

Specialty

Orthopedic Surgery

Education

University of Kansas School of Med (KC/Wich/Sal), 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athletic Orthopedic and Knee CenterGroup PAC ID 5092798405, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Athletic Orthopedic & Knee Center

  • Orthopaedic Surgery Physician
  • Houston, TX
  • NPI 1154346971
  Medicare reassignment Care Compare group NPD Authorized official
• Houston Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Houston, TX
  • NPI 1558782268
  NPD (past)

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1295733285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9180 KATY FREEWAY",
            "address_2": "STE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77055",
            "telephone_number": "713-984-1400",
            "fax_number": "713-647-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9180 KATY FWY SUITE 200",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770557454",
            "telephone_number": "713-984-1400",
            "fax_number": "713-984-0544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "JACK",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TX",
            "license": "F1071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "760281931",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "82376Z",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX LICENSE NUMBER",
            "identifier": "F1071",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jensen Kidney Clinic, Inc.
• Brett T Jensen
• Corey Tyler Jensen, M.D.
• Craig Jensen, MD
• Deann M Jensen, COTA
• Jillene Brack Jensen
• Kathryn Anne Jensen, MS, LCPC, CAADC
• Krystal Jensen, M.D.
• Leila Marie Jensen, PTA, LMT
• Lita Jensen

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; 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.