Active NPI
Jesse Bruton III, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Waco, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 1003730
- 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
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
Medicare enrollment records 1
Medicare enrollment files| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Houston Psychiatry Healthcare PA | Current | Accepting new patients | |
| Gateway Psych Care PLLC | Current | 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 1003730 | TX | Primary |
Addresses
NPPES NPI RegistryPrimary 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| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003730 | Other | TX | TEXAS 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.