Individual provider Active NPI

Joshua Jacome, PA

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1619237179
Registry record updated Feb 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA07706 Issued in TX
Practice address
1515 Holcombe Blvd
Houston, TX 77030
Phone
(713) 792-6161
NPI assigned
May 18, 2012
Last updated
Feb 21, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2019

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 PA07706 TX Primary

Addresses

Primary practice location

1515 Holcombe Blvd
Houston, TX 77030

Mailing address

P O Box 4439
Houston, TX 77210-4439
Phone (713) 792-2991

Other practice location 1

1515 Holcombe Blvd
Unit 432
Houston, TX 77030-4000
Phone (713) 792-6363 ext. 31464

Other identifiers 2

IdentifierTypeStateIssuer
8596NFOtherTXBCBS
336330101MedicaidTX

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
I20140509001981 TX Practitioner - Physician Assistant 8921231325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
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)

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
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: jjacome13052@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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1337299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1619237179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 4439",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104439",
            "telephone_number": "713-792-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 HOLCOMBE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77030",
            "telephone_number": "713-792-6161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 Holcombe Blvd",
            "address_2": "Unit 432",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770304000",
            "country_code": "US",
            "telephone_number": "713-792-6363 x31464",
            "fax_number": "713-792-1220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOME",
        "first_name": "JOSHUA",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-18",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8596NF",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "336330101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.