Individual provider Active NPI

Jacalyn N. Johnson-Alviza, MS, PA-C

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1609944297
Registry record updated Jul 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA05001 Issued in TX
Practice address
1220 Holcombe Blvd
Unit 1258
Houston, TX 77030-4004
Phone
(713) 563-8500
Fax
(713) 563-8501
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA05001 TX Primary

Addresses

Primary practice location

1220 Holcombe Blvd
Unit 1258
Houston, TX 77030-4004

Mailing address

1220 Holcombe Blvd
Unit 1258
Houston, TX 77030-4004
Phone (713) 563-8500

Other identifiers 1

IdentifierTypeStateIssuer
PA05001OtherTXPA LICENSE

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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100809000157 TX Practitioner - Physician Assistant 6800929019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Referral ServiceGroup PAC ID 7911801410, 2,728 clinicians

Practice addresses (Care Compare)

1327 Lake Pointe Pkwy
Sugar Land, TX 77478-4095
Phone (281) 566-1800

2130 W Holcombe Blvd
Univ of TX M D Ande Life Sciences Plaza
Houston, TX 77030-4009
Phone (713) 592-5433

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.29 of 100Reported as group
Quality
70.82
Promoting interoperability
100
Improvement activities
40
Cost
67.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PA05001TXMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: jjohnsonalviza13166@utmdandersoncc.direct-ci.com

Organizations & group practices 1

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 1

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280102400000",
    "number": "1609944297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 HOLCOMBE BLVD",
            "address_2": "UNIT 1258",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304004",
            "telephone_number": "713-563-8500",
            "fax_number": "713-563-8501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 HOLCOMBE BLVD",
            "address_2": "UNIT 1258",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304004",
            "telephone_number": "713-563-8500",
            "fax_number": "713-563-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON-ALVIZA",
        "first_name": "JACALYN",
        "middle_name": "N.",
        "credential": "MS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2010-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PA05001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.