Individual provider Active NPI

Jesse Bruton III, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Waco, TX
National Provider Identifier
1538734751
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1003730 Issued in TX
Practice address
5931 Crosslake Pkwy
Waco, TX 76712-6986
Phone
(254) 870-4874
Fax
(254) 301-7627
NPI assigned
May 20, 2021
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

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.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gateway Psych Care PLLC 10 clinicians

Practice addresses (Care Compare)

5931 Crosslake Pkwy
Waco, TX 76712-6986
Phone (254) 870-4874

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.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20250110001677 TX Practitioner - Nurse Practitioner 0648708289 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Houston Psychiatry Healthcare PA CurrentSince Dec 20, 2024 Accepting new patients
Gateway Psych Care PLLC CurrentSince Dec 10, 2024 Accepting new patients

Locations

104 Whispering Pines Ave
Friendswood, TX 77546
Phone (281) 819-1438

2437 Bay Area Blvd
Houston, TX 77058
Phone (281) 944-4701

4000 Spencer Hwy
Pasadena, TX 77504
Phone (713) 359-1000

2700 Cullen Blvd
Unit 84407
Pearland, TX 77584

12234 Shadow Creek Pkwy
Bldg 4
Pearland, TX 77584
Phone (281) 668-8822

5931 Crosslake Pkwy
Waco, TX 76712
Phone (254) 279-6199

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1003730 TX Primary

Addresses

NPPES NPI Registry

Primary practice location

5931 Crosslake Pkwy
Waco, TX 76712-6986

Mailing address

5931 Crosslake Pkwy
Waco, TX 76712-6986
Phone (254) 870-4874

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1003730OtherTXTEXAS BOARD OF NURSING

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 29, 2025.

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1538734751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5931 CROSSLAKE PKWY",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767126986",
            "telephone_number": "254-870-4874",
            "fax_number": "254-301-7627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5931 CROSSLAKE PKWY",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767126986",
            "telephone_number": "254-870-4874",
            "fax_number": "254-301-7627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUTON",
        "first_name": "JESSE",
        "name_suffix": "III",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-20",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1003730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF NURSING",
            "identifier": "1003730",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.