Individual provider Active NPI

Jaculeen Ann Dano, M.D.

  • Dermatology Physician
  • Austin, TX
National Provider Identifier
1619005840
Registry record updated Jul 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
J4761 Issued in TX
Practice address
1600 W 38TH St
Suite 315
Austin, TX 78731-6400
Phone
(512) 302-4047
Fax
(512) 419-9717
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X J4761 TX Primary

Addresses

Primary practice location

1600 W 38TH St
Suite 315
Austin, TX 78731-6400

Mailing address

1600 W 38TH St
Suite 315
Austin, TX 78731-6400
Phone (512) 302-4047

Other identifiers 1

IdentifierTypeStateIssuer
0051DROtherTXBCBS ID

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
I20050907000991 TX Practitioner - Dermatology 7618909987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Tulane University School of Medicine, 1990
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1600 W 38TH St
Suite 315
Austin, TX 78731-6406
Phone (512) 302-4047

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions461
Removal or shaving of skin growth15
Skin biopsy465

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J4761TXMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Byrkerwood Skin and Vein Center, P.a. Dermatology Current Accepting new patients
Brykerwood Skin and Vein Center PA Dermatology CurrentSince May 15, 2015 Accepting new patients

Locations

1600 W 38th St
Ste 315
Austin, TX 78731
Phone (512) 302-4047

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406073600000",
    "number": "1619005840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W 38TH ST",
            "address_2": "SUITE 315",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316400",
            "telephone_number": "512-302-4047",
            "fax_number": "512-419-9717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W 38TH ST",
            "address_2": "SUITE 315",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787316400",
            "telephone_number": "512-302-4047",
            "fax_number": "512-419-9717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANO",
        "first_name": "JACULEEN",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2014-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "J4761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "0051DR",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.