Jose Alton Arevalo, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP145690 Issued in TX

Practice address

464 Park Grove Dr
Ste B
Katy, TX 77450-1571

Phone

(832) 449-8411

NPI assigned

Apr 24, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Vintage CFM

  • Primary Care Clinic/Center
  • Katy, TX
  • NPI 1770237620
  Medicare reassignment NPD Authorized official
• Center for Mens Health, Inc

  • Adult Medicine Physician
  • Tulsa, OK
  • NPI 1215337050
  NPD (past)

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

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1396189015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22110 WETHERBURN LN",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774492840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 PARK GROVE DR",
            "address_2": "STE B",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774501571",
            "telephone_number": "832-449-8411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6160 S Yale Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741361930",
            "country_code": "US",
            "telephone_number": "918-497-3140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AREVALO",
        "first_name": "JOSE",
        "middle_name": "ALTON",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-24",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP145690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1396189015",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "admin@vintagecfm.com",
            "affiliation": "N",
            "address_1": "24044 Cinco Village Center Blvd Ste 100",
            "city": "Katy",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774948433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sarah Caroline Araujo Lordeiro, QASP-S
• Kylie Ard
• Theresa Area
• Dainelys Arencibia
• Arete Networks of Texas LLC
• Pedro Martin Arevalo
• Alanna Arguelles, D.D.S.
• Euro de Jesus Arias Fuenmayor, FNP
• Luz Adriana Arias, SLP
• Irene Joy Yola Aribal, MSN, APRN, NP-C

• Family Nurse Practitioner in Katy, TX
• Providers in Katy, 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 Feb 17, 2022; 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.