Individual provider Active NPI

Jana Elizabeth Dejesus, MD

  • Surgery Physician
  • Galveston, TX
National Provider Identifier
1528689304
Registry record updated May 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
BP10071301 Issued in TX
Practice address
301 University Blvd
Galveston, TX 77555-5302
Phone
(409) 772-0531
NPI assigned
May 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X BP10071301 TX Primary

Addresses

Primary practice location

301 University Blvd
Galveston, TX 77555-5302

Mailing address

7575 Autumn Park
San Antonio, TX 78249-4240
Phone (210) 577-0657

Other identifiers 1

IdentifierTypeStateIssuer
BP10071301OtherTXPHYSICIAN IN TRAINING PERMIT

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
I20200623003418 TX Order and Referring Only - General SurgeryPractitioner - General Surgery 9638591472

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1588464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588464000000",
    "number": "1528689304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7575 AUTUMN PARK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782494240",
            "telephone_number": "210-577-0657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775555302",
            "telephone_number": "409-772-0531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJESUS",
        "first_name": "JANA",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-03",
        "last_updated": "2020-05-03",
        "certification_date": "2020-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "BP10071301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN IN TRAINING PERMIT",
            "identifier": "BP10071301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.