NPIMap

Individual provider Active NPI

Jaecel O Shah, M.D.

  • Otolaryngology Physician
  • Conroe, TX
National Provider Identifier
1699020727
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
R1870 Issued in TX
Practice address
1501 River Pointe Dr Ste 120
Conroe, TX 77304-2860
Phone
(936) 539-4700
Fax
(936) 539-6618
NPI assigned
Jul 15, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X R1870 TX Primary

Addresses

Primary practice location

1501 River Pointe Dr Ste 120
Conroe, TX 77304-2860

Mailing address

10740 N Gessner Dr. Ste. 310
Houston, TX 77064-1240
Phone (281) 897-0416

Other practice location 1

2255 E Mossy Oaks Rd Ste 400
Spring, TX 77389-1812
Phone (832) 678-8380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170621001154 TX Practitioner - Otolaryngology 0648548396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Texas Medical School at Houston, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Ear, Nose and Throat Specialists, PLLCGroup PAC ID 5799770202, 123 clinicians

Practice addresses (Care Compare)

20207 Chasewood Park Dr
Suite 100
Houston, TX 77070-1441
Phone (832) 237-2227

Hospital & facility affiliations

  • St Luke'S the Woodlands Hospital Hospital, The Woodlands, TX, CCN 450862
  • Houston Methodist the Woodlands Hospital Hospital, The Woodlands, TX, CCN 670122
  • Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184
  • Houston Methodist Willowbrook Hospital Hospital, Houston, TX, CCN 450844
  • Aspire Hospital Hospital, Conroe, TX, CCN 670093

Merit-based Incentive Payment System (MIPS)

Final score
95.75 of 100Reported as group
Promoting interoperability
95
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Ear, Nose & Throat Specialists, PLLC Otolaryngology CurrentSince Aug 1, 2017 Accepting new patients
Noble Anesthesia Partners, PLLC Past Accepting new patients

Locations

1501 River Pointe Dr
Ste 120
Conroe, TX 77304
Phone (936) 539-4700

4015 Interstate 45 N
Ste 330
Conroe, TX 77304
Phone (936) 539-4700

20207 Chasewood Park Dr
Ste 100
Houston, TX 77070
Phone (281) 364-8844

7900 Fannin St
#1900
Houston, TX 77054
Phone (713) 791-9363

10740 N Gessner Rd
Ste 310
Houston, TX 77064
Phone (281) 897-0416

9301 Pinecroft Dr
Ste 150
Shenandoah, TX 77380
Phone (281) 362-1368

2255 E Mossy Oaks Rd
Ste 400
Spring, TX 77389
Phone (832) 678-8380

Interoperability endpoints

  • Direct secure messaging: jshah122338@directhoustonmethodist.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.

Hospital & facility affiliations 11

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": "1342310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1699020727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10740 N GESSNER DR. STE. 310",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770641240",
            "telephone_number": "281-897-0416",
            "fax_number": "281-890-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 RIVER POINTE DR STE 120",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042860",
            "telephone_number": "936-539-4700",
            "fax_number": "936-539-6618"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2255 E Mossy Oaks Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Spring",
            "state": "TX",
            "postal_code": "773891812",
            "country_code": "US",
            "telephone_number": "832-678-8380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "JAECEL",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-15",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "R1870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.