Individual provider Active NPI

Jeromie Sequitin

  • Surgical Physician Assistant
  • Houston, TX
National Provider Identifier
1750740163
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA10746 Issued in TX
Practice address
6701 Fannin St
Houston, TX 77030-2608
Phone
(832) 824-1000
NPI assigned
Feb 12, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X
Surgical Physician Assistant 363AS0400X PA10746 TX Primary

Addresses

Primary practice location

6701 Fannin St
Houston, TX 77030-2608

Mailing address

6621 Fannin St Ste 610.10
Houston, TX 77030-2358
Phone (832) 824-1000

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
I20200106002067 TX Practitioner - Physician Assistant 5395179071 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children'S Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jsequitin185408@prddirect.texaschildrens.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.

NPI Registry JSON

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678924800000",
    "number": "1750740163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST STE 610.10",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302358",
            "telephone_number": "832-824-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 FANNIN ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302608",
            "telephone_number": "832-824-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEQUITIN",
        "first_name": "JEROMIE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-12",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA10746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.