Jaqlynn Ann Puente

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1107557 Issued in TX

Practice address

1610 S Chadbourne St
San Angelo, TX 76903-8510

Phone

(325) 658-5339

Fax

(325) 223-1480

NPI assigned

Jan 17, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

La Esperanza Clinic IncGroup PAC ID 7416942933, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Shannon Medical Center Hospital, San Angelo, TX, CCN 450571

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• La Esperanza Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • San Angelo, TX
  • NPI 1770584187
  Medicare reassignment Care Compare group NPD
• La Esperanza Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Angelo, TX
  • NPI 1265601371
  NPD
• La Esperanza Clinic, Inc.

  • Federally Qualified Health Center (FQHC)
  • San Angelo, TX
  • NPI 1487424602
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Shannon Medical Center

  • General Acute Care Hospital
  • San Angelo, TX
  • NPI 1992707228
  Care Compare affiliation

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

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681430400000",
    "number": "1669187464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2029 W BEAUREGARD AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769013812",
            "telephone_number": "325-658-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 S CHADBOURNE ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769038510",
            "telephone_number": "325-658-5339",
            "fax_number": "325-223-1480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUENTE",
        "first_name": "JAQLYNN",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-17",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1107557",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1107557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andreas Protopapas, M.D.
• Lynsie Provost, RBT
• Cindi Pruitt
• Kaylee Pruitt
• Psychspring, P.L.L.C.
• Julian Zethimus Puente, EMT
• John Jeff Pulley, L-ATC, CSCS
• Alexandra Pustka
• Lina M Quan-Aston, PA
• Camille Quesada, MAT, LAT, ATC

• Nurse Practitioner in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.