Individual provider Active NPI

Nicholette Jacquelyn Ty, MSN, RN, FNP-C

  • Family Nurse Practitioner
  • Sugar Land, TX
National Provider Identifier
1619534278
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP141437 Issued in TX
Practice address
15035 Southwest Fwy
Sugar Land, TX 77478-5018
Phone
(713) 486-7000
NPI assigned
May 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP141437 TX Primary

Addresses

Primary practice location

15035 Southwest Fwy
Sugar Land, TX 77478-5018

Mailing address

15035 Southwest Fwy
Sugar Land, TX 77478-5018
Phone (713) 486-7000

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
I20190808003216 TX Practitioner - Nurse Practitioner 3678800950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut PhysiciansGroup PAC ID 8426960360, 1,744 clinicians

Practice addresses (Care Compare)

15035 Southwest Fwy
Sugar Land, TX 77478-5018
Phone (713) 486-7000

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
AP141437TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Jul 5, 2019 Accepting new patients
Ut Physicians CurrentSince Jul 5, 2019 Accepting new patients

Locations

5420 West Loop S
Ste 2400
Bellaire, TX 77401
Phone (713) 314-4600

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

15035 Southwest Fwy
Sugar Land, TX 77478
Phone (281) 344-1715

Interoperability endpoints

  • Direct secure messaging: nty13829@direct.uth.org

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": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1619534278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15035 SOUTHWEST FWY",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774785018",
            "telephone_number": "713-486-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15035 SOUTHWEST FWY",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774785018",
            "telephone_number": "713-486-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TY",
        "first_name": "NICHOLETTE",
        "middle_name": "JACQUELYN",
        "credential": "MSN, RN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-20",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP141437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.