Individual provider Active NPI

Jenny Neziroski, NP

  • Family Nurse Practitioner
  • Kingwood, TX
National Provider Identifier
1710407713
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP134162 Issued in TX
Practice address
2855 W Lake Houston Pkwy Ste 101
Kingwood, TX 77339-5219
Phone
(281) 812-4447
NPI assigned
Jun 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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 AP134162 TX Primary

Addresses

Primary practice location

2855 W Lake Houston Pkwy Ste 101
Kingwood, TX 77339-5219

Mailing address

2855 W Lake Houston Pkwy Ste 101
Kingwood, TX 77339-5219
Phone (281) 812-4447

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
I20180109000719 TX Practitioner - Nurse Practitioner 9032478565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hermann Medical GroupGroup PAC ID 7012008360, 760 clinicians

Practice addresses (Care Compare)

2855 W Lake Houston Pkwy
Kingwood, TX 77339-5219

915 Gessner Rd
Suite 100
Houston, TX 77024-2537
Phone (713) 242-2222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP134162TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hermann Medical Group CurrentSince Jun 15, 2020 Accepting new patients

Locations

1505 E Winding Way Dr
Ste 200
Friendswood, TX 77546
Phone (713) 366-7800

915 Gessner Rd
Ste 100
Houston, TX 77024
Phone (713) 242-2222

909 Frostwood Dr
Ste 1100
Houston, TX 77024
Phone (713) 338-4523

1801 North Loop W
Ste 30
Houston, TX 77008
Phone (713) 802-9781

2855 W Lake Houston Pkwy
Ste 101
Kingwood, TX 77339
Phone (281) 812-4447

3203 Broadway St
Pearland, TX 77581
Phone (281) 485-8876

Interoperability endpoints

  • Direct secure messaging: jneziroski66420@memorialhermann.direct-ci.com

Organizations & group practices 1

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": "1498003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1710407713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 W LAKE HOUSTON PKWY STE 101",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773395219",
            "telephone_number": "281-812-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 W LAKE HOUSTON PKWY STE 101",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773395219",
            "telephone_number": "281-812-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEZIROSKI",
        "first_name": "JENNY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-21",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP134162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, TX

Sources for this page

Verify at the official NPI Registry.