Individual provider Active NPI

Amanda Jagolino-Cole, MD

  • Vascular Neurology Physician
  • Houston, TX
National Provider Identifier
1609192087
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Neurology PhysicianTaxonomy code 2084V0102X
License
Q0770 Issued in TX
Practice address
6410 Fannin St Ste 1014
Houston, TX 77030-5301
Phone
(719) 500-7087
NPI assigned
Apr 11, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X Q0770 TX
Vascular Neurology Physician 2084V0102X Q0770 TX Primary

Addresses

Primary practice location

6410 Fannin St Ste 1014
Houston, TX 77030-5301

Mailing address

6431 Fannin St
MSB 7.125
Houston, TX 77030-1501

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
I20150519001912 TX Practitioner - Neurology 4789904509 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ut PhysiciansGroup PAC ID 2961732193, 206 clinicians

Practice addresses (Care Compare)

11920 Astoria Blvd
Suite 292
Houston, TX 77089-6155
Phone (713) 486-7970

6411 Fannin St
Houston, TX 77030-1501
Phone (713) 704-4000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians Neurology CurrentSince Jul 1, 2015 Accepting new patients
Ut Physicians CurrentSince Jul 1, 2015 Accepting new patients
Ut Physicians CurrentSince Sep 1, 2020 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

11920 Astoria Blvd
Ste 292
Houston, TX 77089
Phone (713) 486-7970

6431 Fannin St
#7125
Houston, TX 77030

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

6410 Fannin St
Ste 1014
Houston, TX 77030
Phone (713) 500-7100

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

8810 Highway 6
Ste 100
Sienna Plantation, TX 77459
Phone (713) 486-1200

Organizations & group practices 4

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 2

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": "1270944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1609192087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6431 FANNIN ST",
            "address_2": "MSB 7.125",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST STE 1014",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770305301",
            "telephone_number": "719-500-7087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGOLINO-COLE",
        "first_name": "AMANDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-11",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "Q0770",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "TX",
            "license": "Q0770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.