Individual provider Active NPI

Brenda Darquisha Vasiljevich, NP-C

  • Primary Care Nurse Practitioner
  • Houston, TX
National Provider Identifier
1417490798
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AP132021 Issued in TX
Practice address
4545 Post Oak Place Dr
#130
Houston, TX 77027-3164
Phone
(713) 297-7133
Fax
(832) 553-2941
NPI assigned
Nov 18, 2016
Last updated
Sep 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X AP132021 TX Primary

Addresses

Primary practice location

4545 Post Oak Place Dr
#130
Houston, TX 77027-3164

Mailing address

4545 Post Oak Place Dr
#130
Houston, TX 77027-3164
Phone (713) 297-7133

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170220001696 TX Practitioner - Nurse Practitioner 0042593907 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP132021TXMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hermann Medical Group CurrentSince May 22, 2022 Accepting new patients
Ipc Healthcare Services of Texas, PLLC CurrentSince Oct 1, 2018 Accepting new patients
Lonestar Hospital Medicine Associates, PA CurrentSince Jan 9, 2017 Accepting new patients
Prime Hospitalist Partners, LLC CurrentSince Jun 18, 2021 Accepting new patients

Locations

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

504 Medical Center Blvd
Conroe, TX 77304
Phone (936) 539-1111

504 Medical Center Blvd
#300
Conroe, TX 77304
Phone (936) 230-5358

1505 E Winding Way Dr
Ste 200
Friendswood, TX 77546
Phone (713) 366-7800

1801 North Loop W
Ste 30
Houston, TX 77008
Phone (713) 802-9781

4545 Post Oak Place Dr
Ste 130
Houston, TX 77027
Phone 7139608008107

700 Louisiana St
Ste 3950
Houston, TX 77002
Phone (346) 712-0177

915 Gessner Rd
Ste 100
Houston, TX 77024
Phone (713) 242-2222

22999 Highway 59 N
Kingwood, TX 77339
Phone (281) 348-3322

17516 US Highway 59
Ste 110
New Caney, TX 77357
Phone (832) 478-0200

11800 Astoria Blvd
Pearland, TX 77089
Phone (281) 929-6100

3203 Broadway St
Pearland, TX 77581
Phone (281) 485-8876

111 Dallas St
San Antonio, TX 78205
Phone (210) 297-7000

6801 Emmett F Lowry Expy
Texas City, TX 77591
Phone (409) 938-5095

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1479427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1417490798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 POST OAK PLACE DR",
            "address_2": "#130",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770273164",
            "telephone_number": "713-297-7133",
            "fax_number": "832-553-2941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 POST OAK PLACE DR",
            "address_2": "#130",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770273164",
            "telephone_number": "713-297-7133",
            "fax_number": "832-553-2941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASILJEVICH",
        "first_name": "BRENDA",
        "middle_name": "DARQUISHA",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-18",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP132021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.