Individual provider Active NPI

Eduardo Leon Jaramillo, M.D.

  • Obstetrics & Gynecology Physician
  • Decatur, TX
National Provider Identifier
1790079929
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
Q2908 Issued in TX
Practice address
2451 S FM 51 Ste 200
Decatur, TX 76234-3860
Phone
(940) 627-2409
Fax
(940) 626-4579
NPI assigned
Jun 6, 2011
Last updated
Feb 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X Q2908 TX Primary

Addresses

Primary practice location

2451 S FM 51 Ste 200
Decatur, TX 76234-3860

Mailing address

PO Box 2078
Decatur, TX 76234-6156
Phone (940) 627-2409

Other identifiers 2

IdentifierTypeStateIssuer
179009929MedicaidTX
PENDINGOtherTXBCBSTX

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
I20220325001055 TX Practitioner - Obstetrics/Gynecology 7719115062 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Texas Medical Branch at Galveston, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Decatur Physician Services PLLCGroup PAC ID 6800247164, 5 clinicians

Practice addresses (Care Compare)

2451 S FM
51 Suite 200
Decatur, TX 76234-3860
Phone (940) 627-2409

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Decatur Hospital Authority Current Accepting new patients
Decatur Physician Services PLLC CurrentSince Dec 25, 2023 Accepting new patients
Wise Clinical Care Associates Obstetrics & Gynecology CurrentSince Feb 1, 2022 Accepting new patients
Eduardo L Jaramillo MD PA Obstetrics & Gynecology Past Accepting new patients
Columbia Medical Center of Denton Subsidiary LP Past Accepting new patients
Wise Clinical Care Associates PastSince Feb 6, 2022 Accepting new patients

Locations

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

133 N FM 730
Unit 105
Boyd, TX 76023
Phone (940) 433-2151

1821 S FM 51
Decatur, TX 76234
Phone (855) 277-2979

2014 Ben Merritt Dr
Ste A
Decatur, TX 76234
Phone (940) 249-9009

2014 Ben Merritt Dr
Ste B
Decatur, TX 76234
Phone (940) 626-2962

2451 S FM 51
Ste 200
Decatur, TX 76234
Phone (940) 627-2409

Interoperability endpoints

  • Direct secure messaging: eduardo.jaramillo@hca7.eclinicaldirectplus.com
  • Direct secure messaging: eduardojaramillo2@wise.allscriptsdirect.net
  • Direct secure messaging: jr@eduardojaramillo.direct.emds.com

Organizations & group practices 6

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.

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": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643673600000",
    "number": "1790079929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2078",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762346156",
            "telephone_number": "940-627-2409",
            "fax_number": "940-626-4579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 S FM 51 STE 200",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343860",
            "telephone_number": "940-627-2409",
            "fax_number": "940-626-4579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARAMILLO",
        "first_name": "EDUARDO",
        "middle_name": "LEON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-06",
        "last_updated": "2022-02-01",
        "certification_date": "2022-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "Q2908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179009929",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "PENDING",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, TX

Sources for this page

Verify at the official NPI Registry.