Active NPI
Jana Elizabeth Dejesus, MD
- Surgery Physician
- Galveston, TX
National Provider Identifier
1528689304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- BP10071301
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| BP10071301 | Other | TX | PHYSICIAN 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200623003418 | TX | Order and Referring Only - 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.