Individual provider Active NPI

Jennifer Jernberg, MD, PHD

  • Psychiatry Physician
  • Houston, TX
National Provider Identifier
1770119687
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
V1800 Issued in TX
Practice address
5615 H Mark Crosswell Jr St
Houston, TX 77021-1080
Phone
(713) 741-5050
NPI assigned
Mar 23, 2020
Last updated
Jul 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Psychiatry Physician 2084P0800X V1800 TX Primary

Addresses

Primary practice location

5615 H Mark Crosswell Jr St
Houston, TX 77021-1080

Mailing address

5615 H Mark Crosswell Jr St
Houston, TX 77021-1080
Phone (713) 741-5050

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240806003078 TX Practitioner - Psychiatry 5597189837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians Psychiatry CurrentSince Jul 15, 2024 Accepting new patients
Ut Physicians CurrentSince Jul 15, 2024 Accepting new patients
University of Texas Health Science Center at Houston Past Accepting new patients

Locations

6410 Fannin St
#135
Houston, TX 77030

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1770119687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5615 H MARK CROSSWELL JR ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770211080",
            "telephone_number": "713-741-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5615 H MARK CROSSWELL JR ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770211080",
            "telephone_number": "713-741-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JERNBERG",
        "first_name": "JENNIFER",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-23",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "V1800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.