Individual provider Active NPI

Jessica Maxwell, MD, MBA

  • Surgery Physician
  • Houston, TX
National Provider Identifier
1487949905
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
R6242 Issued in TX
Practice address
1515 Holcombe Blvd
Houston, TX 77030-4000
Phone
(713) 792-6161
NPI assigned
Jun 13, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X R-9231 IA
Surgery Physician 208600000X R6242 TX Primary

Addresses

Primary practice location

1515 Holcombe Blvd
Houston, TX 77030-4000

Mailing address

200 Hawkins Dr
Dept. of Surgery
Iowa City, IA 52242-1007
Phone (319) 356-1616

Other practice location 1

200 Hawkins Dr
Dept. of Surgery
Iowa City, IA 52242-1007
Phone (319) 356-1616

Other identifiers 2

IdentifierTypeStateIssuer
388193001MedicaidTX
388193002OtherTXMEDICAID CSHCN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180709002362 TX Practitioner - General SurgeryPractitioner - Surgical Oncology 9032351440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Surgical Oncology
Education
University of Iowa, RJ & L Carver College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physicians Referral ServiceGroup PAC ID 7911801410, 2,728 clinicians

Practice addresses (Care Compare)

1515 Holcombe Blvd
Houston, TX 77030-4000
Phone (713) 792-6127

Hospital & facility affiliations

  • University of Texas M D Anderson Cancer Center Hospital, Houston, TX, CCN 450076

Merit-based Incentive Payment System (MIPS)

Final score
84.29 of 100Reported as group
Quality
70.82
Promoting interoperability
100
Improvement activities
40
Cost
67.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R-9231IAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Referral Service CurrentSince Jun 5, 2018 Accepting new patients

Locations

1515 Holcombe Blvd
Houston, TX 77030
Phone (713) 794-5446

1515 Holcombe Blvd
#R4212
Houston, TX 77030
Phone (713) 794-5446

1515 Holcombe Blvd
#M
Houston, TX 77030
Phone (713) 792-6127

Organizations & group practices 1

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": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1487949905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWKINS DR",
            "address_2": "DEPT. OF SURGERY",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522421007",
            "telephone_number": "319-356-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 HOLCOMBE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304000",
            "telephone_number": "713-792-6161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hawkins Dr",
            "address_2": "Dept. of Surgery",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421007",
            "country_code": "US",
            "telephone_number": "319-356-1616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAXWELL",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "MD, MBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-13",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IA",
            "license": "R-9231",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "R6242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "388193001",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID CSHCN",
            "identifier": "388193002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.