Individual provider Active NPI

Matthew Roy Jacobsen, CRNA

  • Certified Registered Nurse Anesthetist
  • Houston, TX
National Provider Identifier
1669454476
Registry record updated Apr 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP114088 Issued in TX
Practice address
1500 Citywest Blvd Ste 300
Houston, TX 77042-2549
Phone
(713) 620-4000
NPI assigned
Nov 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 688836 TX
Certified Registered Nurse Anesthetist 367500000X AP114088 TX Primary

Addresses

Primary practice location

1500 Citywest Blvd Ste 300
Houston, TX 77042-2549

Mailing address

PO Box 840853
Dallas, TX 75284-8423
Phone (713) 620-4000

Other practice location 1

17207 Kuykendahl Rd
#200
Spring, TX 77379-8423
Phone (832) 698-5320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050815000145 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153351788 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
U S Anesthesia Partners of Texas, PAGroup PAC ID 7315850351, 2,750 clinicians

Practice addresses (Care Compare)

1500 Citywest Blvd
Suite 300
Houston, TX 77042-2549
Phone (713) 620-4000

Hospital & facility affiliations

  • HCA Houston Healthcare Tomball Hospital, Tomball, TX, CCN 450670

Merit-based Incentive Payment System (MIPS)

Final score
88.94 of 100Reported as group
Quality
91.31
Improvement activities
40
Cost
79.05

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Best Choice Anesthesia & Pain PLLC CurrentSince May 26, 2013 Accepting new patients
U S Anesthesia Partners of Texas, PA Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2019 Accepting new patients
U. S. Anesthesia Partners of Texas, P.a., Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2019 Accepting new patients

Locations

710 FM 1960 Rd W
Houston, TX 77090
Phone (281) 440-1000

1500 Citywest Blvd
Ste 300
Houston, TX 77042
Phone (713) 458-4185

7010 Champions Plaza Dr
Ste 300
Houston, TX 77069
Phone (832) 698-5320

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

19226 Stonehue
Ste 103
San Antonio, TX 78258
Phone (210) 268-0100

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

605 Holderrieth Blvd
Tomball, TX 77375
Phone (281) 401-7500

6720 Bertner Ave
Va Hospital, TX 77030
Phone (713) 785-8537

Organizations & group practices 3

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": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588032000000",
    "number": "1669454476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752848423",
            "telephone_number": "713-620-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CITYWEST BLVD STE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770422549",
            "telephone_number": "713-620-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17207 Kuykendahl Rd",
            "address_2": "#200",
            "address_purpose": "LOCATION",
            "city": "Spring",
            "state": "TX",
            "postal_code": "773798423",
            "country_code": "US",
            "telephone_number": "832-698-5320",
            "fax_number": "832-698-5321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACOBSEN",
        "first_name": "MATTHEW",
        "middle_name": "ROY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2020-04-28",
        "certification_date": "2020-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "688836",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "AP114088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.