Individual provider Active NPI

Jeanan Alameddine, CPNP-AC

  • Pediatric Nurse Practitioner
  • Missouri City, TX
National Provider Identifier
1457965436
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1011810 Issued in TX
Practice address
823 Catalpa PL
Missouri City, TX 77459-5709
Phone
(281) 948-3916
NPI assigned
Sep 7, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 1011810 TX Primary

Addresses

Primary practice location

823 Catalpa PL
Missouri City, TX 77459-5709

Mailing address

6410 Fannin St Ste 370
Houston, TX 77030-3004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20260211000220 NY Practitioner - Nurse Practitioner 9032500061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1 Park Ave FL
Suite 11
New York, NY 10016-5818

700 Hicksville Rd
Bethpage, NY 11714-3471

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1011810TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Dec 22, 2025 Accepting new patients
New York University CurrentSince Dec 22, 2025 Accepting new patients
Ut Physicians CurrentSince Dec 6, 2021 Accepting new patients
Ut Physicians CurrentSince Dec 6, 2021 Accepting new patients

Locations

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

6410 Fannin St
Ste 370
Houston, TX 77030
Phone (713) 486-6755

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": "1599436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1457965436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST STE 370",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 CATALPA PL",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774595709",
            "telephone_number": "281-948-3916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAMEDDINE",
        "first_name": "JEANAN",
        "credential": "CPNP-AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-07",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1011810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missouri City, TX

Sources for this page

Verify at the official NPI Registry.