Individual provider Active NPI

Jennifer Lan Nakamura, M.D.

  • Internal Medicine Physician
  • Austin, TX
National Provider Identifier
1306112735
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD207322 Issued in LA
Practice address
3200 Red River St Ste 201
Austin, TX 78705-2655
Phone
(855) 481-8375
NPI assigned
Mar 29, 2012
Last updated
May 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X MD207322 LA Primary

Addresses

Primary practice location

3200 Red River St Ste 201
Austin, TX 78705-2655

Mailing address

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-4000

Other identifiers 3

IdentifierTypeStateIssuer
06758749MedicaidMS
AP111699OtherTXTX LICENSE
2192329MedicaidLA

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
I20190903001530 TX Practitioner - Internal Medicine 0547578759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Temple University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Harbor Health Medical GroupGroup PAC ID 8921482597, 46 clinicians

Practice addresses (Care Compare)

505 W Louis Henna Blvd
Suite 100
Austin, TX 78728-1702
Phone (855) 481-8375

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Health Medical Group Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients

Locations

3200 Red River St
Ste 201
Austin, TX 78705
Phone (512) 473-0201

505 W Louis Henna Blvd
Ste 100
Austin, TX 78728
Phone (512) 252-1505

911 W 38th St
Ste 101
Austin, TX 78705
Phone (512) 600-2888

177 Kirkham Cir
Kyle, TX 78640
Phone (512) 405-0077

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/28292/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jennifer.nakamura.1@28292.direct.athenahealth.com

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.

Hospital & facility affiliations 1

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": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1306112735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 RED RIVER ST STE 201",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787052655",
            "telephone_number": "855-481-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAMURA",
        "first_name": "JENNIFER",
        "middle_name": "LAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-29",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD207322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06758749",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX LICENSE",
            "identifier": "AP111699",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2192329",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.