Individual provider Active NPI

Jaisy Jose Kandanattu, APRN

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1669867180
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP127404 Issued in TX
Practice address
6410 Fannin St Ste 1508
Houston, TX 77030-5306
Phone
(713) 486-6130
NPI assigned
Apr 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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 AP127404 TX Primary

Addresses

Primary practice location

6410 Fannin St Ste 1508
Houston, TX 77030-5306

Mailing address

250 Blossom St Ste 120
Webster, TX 77598-4243
Phone (713) 973-7246

Other practice location 1

16701 Creek Bend Dr
Sugar Land, TX 77478-3752
Phone (281) 265-0409

Other practice location 2

16701 Creek Bend Dr
Sugar Land, TX 77478-3752
Phone (281) 265-0409

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
I20151214000927 TX Practitioner - Nurse Practitioner 7012218258 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
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)

6411 Fannin St
Houston, TX 77030-1501
Phone (713) 704-0093

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP127404TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Apr 9, 2018 Accepting new patients
Ut Physicians CurrentSince Apr 9, 2018 Accepting new patients
Cardiovascular Care Providers, Inc. Past Accepting new patients

Locations

5656 Kelley St
Houston, TX 77026
Phone (713) 566-5000

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

9434 Katy Fwy
Ste 408
Houston, TX 77055

1900 North Loop W
Ste 600
Houston, TX 77018
Phone (281) 502-0002

6431 Fannin St
#2130B
Houston, TX 77030
Phone (713) 500-7631

6410 Fannin St
Ste 1508
Houston, TX 77030
Phone (713) 486-6130

6431 Fannin St
Ste G605
Houston, TX 77030

6411 Fannin St
Houston, TX 77030
Phone (713) 500-6200

Interoperability endpoints

  • Direct secure messaging: jkandanattu43197@memorialhermann.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1669867180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 BLOSSOM ST STE 120",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984243",
            "telephone_number": "713-973-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 FANNIN ST STE 1508",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770305306",
            "telephone_number": "713-486-6130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16701 Creek Bend Dr",
            "address_purpose": "LOCATION",
            "city": "Sugar Land",
            "state": "TX",
            "postal_code": "774783752",
            "country_code": "US",
            "telephone_number": "281-265-0409",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16701 Creek Bend Dr",
            "address_purpose": "LOCATION",
            "city": "Sugar Land",
            "state": "TX",
            "postal_code": "774783752",
            "country_code": "US",
            "telephone_number": "281-265-0409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANDANATTU",
        "first_name": "JAISY",
        "middle_name": "JOSE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-01",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP127404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.