Individual provider Active NPI

John Nicholas Hustedt, NP

  • Nurse Practitioner
  • The Woodlands, TX
National Provider Identifier
1447748504
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP136420 Issued in TX
Practice address
17200 St Lukes Way
The Woodlands, TX 77384-8007
Phone
(713) 540-3620
NPI assigned
Apr 24, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP136420 TX Primary

Addresses

Primary practice location

17200 St Lukes Way
The Woodlands, TX 77384-8007

Mailing address

2038 Lake Creek Dr
Kingwood, TX 77339-1760
Phone (713) 540-3620

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
I20180914000212 TX Practitioner - Nurse Practitioner 9739439605 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Travis County Emergency Physicians PAGroup PAC ID 0840289468, 289 clinicians

Practice addresses (Care Compare)

6565 Fannin St
Houston, TX 77030-2703
Phone (713) 790-3311

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Travis County Emergency Physicians PA Emergency Medicine CurrentSince Jul 19, 2023 Accepting new patients
Integrative Emergency Services Physician Group-Houston PLLC Emergency Medicine CurrentSince Apr 1, 2020 Accepting new patients
Medical Center Emergency Physicians PA Emergency Medicine Past Accepting new patients
Methodist Health Centers Past Accepting new patients

Locations

7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305

2615 Southwest Fwy
Ste 140
Houston, TX 77098
Phone (713) 441-2779

540 Interstate 45 S
Ste E
Huntsville, TX 77340
Phone (936) 755-8288

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

1310 E League City Pkwy
League City, TX 77573
Phone (346) 427-5050

5161 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (281) 810-9326

11713 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 793-4600

11525 Broadway St
Pearland, TX 77584
Phone (713) 363-8020

3011 W Loop 1604 N
San Antonio, TX 78251
Phone (726) 266-7081

17201 Interstate 45 S
The Woodlands, TX 77385
Phone (936) 270-2000

17200 St Lukes Way
The Woodlands, TX 77384
Phone (936) 266-2008

6565 Fannin St
Va Hospital, TX 77030
Phone (713) 394-6000

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685577600000",
    "number": "1447748504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2038 LAKE CREEK DR",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773391760",
            "telephone_number": "713-540-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17200 ST LUKES WAY",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773848007",
            "telephone_number": "713-540-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSTEDT",
        "first_name": "JOHN",
        "middle_name": "NICHOLAS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-24",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP136420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

Verify at the official NPI Registry.