Individual provider Active NPI

Jared Christiansen, PA

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1467622852
Registry record updated Mar 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA05496 Issued in TX
Practice address
7600 Beechnut St.
Houston, TX 77074-4389
Phone
(713) 456-5151
NPI assigned
Mar 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA05496 TX Primary

Addresses

Primary practice location

7600 Beechnut St.
Houston, TX 77074-4389

Mailing address

5423 W Farm Way
Fulshear, TX 77441-3713
Phone (503) 949-4086

Other identifiers 1

IdentifierTypeStateIssuer
PA05496OtherTXTX. LICENSE

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
I20080502000370 TX Practitioner - Physician Assistant 8224117189 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hunt Regional Urgent CareGroup PAC ID 1850729682, 31 clinicians

Practice addresses (Care Compare)

2800 State Hwy 24
Suite C
Commerce, TX 75428-2017
Phone (903) 886-1055

3206 Interstate 30
Suite B
Greenville, TX 75402-7002
Phone (903) 408-7979

5000 E Interstate Hwy 30
Suite 120
Fate, TX 75189-8848
Phone (469) 580-0338

576 W Interstate 30
Royse City, TX 75189-7538
Phone (469) 351-0100

810 E Ralph Hall Pkwy
Suite 100
Rockwall, TX 75032-6879
Phone (469) 402-3400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA05496TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hunt Memorial Hospital District CurrentSince Jul 8, 2024 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Nov 1, 2016 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Nov 1, 2016 Accepting new patients
Plano Urgent Care LLC PastSince Jul 1, 2014 Accepting new patients

Locations

1105 Central Expy N
Allen, TX 75013
Phone (972) 747-4313

5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396

8200 Walnut Hill Ln
Dallas, TX 75231
Phone (214) 345-6148

1301 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 250-2000

4211 Joe Ramsey Blvd E
Ste 100
Greenville, TX 75401
Phone (903) 408-7700

3206 Interstate Highway 30
Ste B
Greenville, TX 75402
Phone (903) 408-7979

4215 Ramsey Blvd E
Greenville, TX 75401
Phone (903) 408-1470

7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300

810 E Ralph Hall Pkwy
Ste 100
Rockwall, TX 75032
Phone (469) 402-3400

Organizations & group practices 11

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.

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": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425427200000",
    "number": "1467622852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5423 W FARM WAY",
            "city": "FULSHEAR",
            "state": "TX",
            "postal_code": "774413713",
            "telephone_number": "503-949-4086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 BEECHNUT ST.",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770744389",
            "telephone_number": "713-456-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIANSEN",
        "first_name": "JARED",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-03",
        "last_updated": "2015-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX. LICENSE",
            "identifier": "PA05496",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.