Selina A Jeanise, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

S7075 Issued in TX

Practice address

1333 S Sam Houston Blvd
Houston, MO 65483-2046

Phone

(417) 967-5435

NPI assigned

Jul 7, 2010

Last updated

Nov 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Acs Primary Care Physicians Southwest PAGroup PAC ID 1850204363, 188 clinicians

Integrative Emergency Services Physician Group-Houston PLLCGroup PAC ID 7113258500, 212 clinicians

Angelina Emergency Medicine Associates PAGroup PAC ID 5395973564, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Woodland Heights Medical Center Hospital, Lufkin, TX, CCN 450484
• Nacogdoches Medical Center Hospital, Nacogdoches, TX, CCN 450656
• CHI St Lukes Health Memorial Lufkin Hospital, Lufkin, TX, CCN 450211
• The Medical Center of Southeast Texas Hospital, Port Arthur, TX, CCN 450518

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sjeanise867891@ahs.direct-ci.com

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.

• Acs Primary Care Physicians Southwest, PA

  • Emergency Medicine Physician
  • Gainesville, TX
  • NPI 1538101019
  Medicare reassignment Care Compare group NPD
• Angelina Emergency Medicine Associates PA

  • Emergency Medicine Physician
  • Lufkin, TX
  • NPI 1518397298
  Medicare reassignment Care Compare group NPD
• Integrative Emergency Services Physician Group-Houston PLLC

  dba IES Houston

  • Emergency Medicine Physician
  • Pasadena, TX
  • NPI 1801458708
  Medicare reassignment Care Compare group NPD
• Bonita Creek Emergency Services PLLC

  • Emergency Medicine Physician
  • Nacogdoches, TX
  • NPI 1902555485
  Medicare reassignment NPD
• Travis County Emergency Physicians PA

  • Emergency Medicine Physician
  • Austin, TX
  • NPI 1962440933
  Medicare reassignment NPD
• Texas County Memorial Hospital

  dba TCMH Internal Medicine Associates

  • Multi-Specialty Clinic/Center
  • Houston, MO
  • NPI 1306885587
  NPD (past)

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

• Hsa Port Arthur, LLC

  • General Acute Care Hospital
  • Port Arthur, TX
  • NPI 1194548073
  Care Compare affiliation
• Memorial Health System of East Texas

  dba CHI St. Lukes Health Memorial Lufkin

  • Rural Acute Care Hospital
  • Lufkin, TX
  • NPI 1396746129
  Care Compare affiliation
• Piney Woods Healthcare System, L.P.

  dba Woodland Heights Medical Center

  • General Acute Care Hospital
  • Lufkin, TX
  • NPI 1487607792
  Care Compare affiliation
• TH Healthcare, LTD

  dba Nacogdoches Medical Center

  • General Acute Care Hospital
  • Nacogdoches, TX
  • NPI 1700885076
  Care Compare affiliation

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

{
    "created_epoch": "1278460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1679885644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12496 BELL RD",
            "city": "ROBY",
            "state": "MO",
            "postal_code": "655578705",
            "telephone_number": "936-676-9575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 S SAM HOUSTON BLVD",
            "city": "HOUSTON",
            "state": "MO",
            "postal_code": "654832046",
            "telephone_number": "417-967-5435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5325 Faraon St",
            "address_purpose": "LOCATION",
            "city": "Saint Joseph",
            "state": "MO",
            "postal_code": "645063488",
            "country_code": "US",
            "telephone_number": "816-271-6122",
            "fax_number": "816-271-6019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4430 Missouri Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Leonard Wood",
            "state": "MO",
            "postal_code": "65473",
            "country_code": "US",
            "telephone_number": "573-596-0456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEANISE",
        "first_name": "SELINA",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-07",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "S7075",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0102203214",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2015040163",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GME",
            "identifier": "390200000X",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Houston R-1 School District
• Houston R-I
• John D Huff, PHARMD
• Steven Charles Hutcheson, PHARMACIST
• Dara Jackson
• Rachel Johnson
• Sierra Keller, COTA/L
• Jerid Land
• Carl W Lange IV, PA
• Jennifer Renee Leggins, PHARMD

• Emergency Medicine Physician in Houston, MO
• Providers in Houston, MO by specialty
• Emergency Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.