Individual provider Active NPI

Jonathan Parks Fillauer

  • Clinical Neuropsychologist
  • League City, TX
National Provider Identifier
1760911564
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
40228 Issued in TX
Practice address
112 Magnolia Estates Dr
League City, TX 77573-4613
Phone
(888) 606-0086
NPI assigned
Jun 6, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 40228 TX Primary
Clinical Psychologist 103TC0700X 40228 TX

Addresses

Primary practice location

112 Magnolia Estates Dr
League City, TX 77573-4613

Mailing address

112 Magnolia Estates Dr
League City, TX 77573-4719
Phone (888) 606-0086

Other practice location 1

7070 Knights Ct Ste 1304
Missouri City, TX 77459-5525
Phone (888) 606-0086

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240704000345 TX Practitioner - Clinical Psychologist 7113380783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neurocognitive Specialty Group PLLCGroup PAC ID 9133451297, 10 clinicians

Practice addresses (Care Compare)

112 Magnolia Estates Dr
League City, TX 77573-4613
Phone (281) 954-6828

Merit-based Incentive Payment System (MIPS)

Final score
82.25 of 100Reported as group
Quality
63.07
Improvement activities
40
Cost
77.51

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40228TXMDClinical Psychologist
4440CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Neurocognitive Specialty Group, PLLC Clinical Neuropsychologist CurrentSince May 1, 2024 Accepting new patients

Locations

112 Magnolia Estates Dr
League City, TX 77573
Phone (281) 954-6828

7070 Knights Ct
Ste 1304
Missouri City, TX 77459
Phone (281) 954-6628

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.

NPI Registry JSON

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1760911564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 MAGNOLIA ESTATES DR",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775734719",
            "telephone_number": "888-606-0086",
            "fax_number": "346-223-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MAGNOLIA ESTATES DR",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775734613",
            "telephone_number": "888-606-0086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7070 Knights Ct Ste 1304",
            "address_purpose": "LOCATION",
            "city": "Missouri City",
            "state": "TX",
            "postal_code": "774595525",
            "country_code": "US",
            "telephone_number": "888-606-0086",
            "fax_number": "346-223-0296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FILLAUER",
        "first_name": "JONATHAN",
        "middle_name": "PARKS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-06",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "40228",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "40228",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in League City, TX

Sources for this page

Verify at the official NPI Registry.