Individual provider Active NPI

Jaesoon Woo Hite, MD

  • Family Medicine Physician
  • Webster, TX
National Provider Identifier
1790871077
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M0755 Issued in TX
Practice address
1010 S Ponds Dr
Webster, TX 77598
Phone
(713) 442-4300
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M0755 TX Primary

Addresses

Primary practice location

1010 S Ponds Dr
Webster, TX 77598

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-0000

Other identifiers 3

IdentifierTypeStateIssuer
171910601MedicaidTX
171910602MedicaidTX
171910603MedicaidTX

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
Direct Messaging Address jhite1960@direct.kelsey-seybold.com Direct

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
I20050325000334 TX Practitioner - Family Practice 2668428384 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey-Seybold Medical Group, PLLC Family Medicine CurrentSince Mar 14, 2005 Accepting new patients
Village Chiropractic and Wellness P.L.L.C. Past Accepting new patients

Locations

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

3023 Marina Bay Dr
Ste 104
League City, TX 77573
Phone (281) 334-7737

7010 Highway 6
Missouri City, TX 77459
Phone (713) 442-4200

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

2515 Business Center Dr
Pearland, TX 77584
Phone (713) 442-7200

16659 Southwest Fwy
Sugar Land, TX 77479
Phone 28147946387

17448 Highway 3
Webster, TX 77598
Phone (713) 442-4300

1010 S Ponds Dr
Bldg A
Webster, TX 77598

1010 S Ponds Dr
Webster, TX 77598
Phone (713) 442-4300

Interoperability endpoints

  • Direct secure messaging: jhite1960@direct.kelsey-seybold.com

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1790871077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 S PONDS DR",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "77598",
            "telephone_number": "713-442-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HITE",
        "first_name": "JAESOON",
        "middle_name": "WOO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "M0755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171910601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171910602",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171910603",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR endpoint URL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1010 S Ponds Dr",
            "city": "Webster",
            "state": "TX",
            "country_code": "US",
            "postal_code": "77598",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhite1960@direct.kelsey-seybold.com",
            "affiliation": "N",
            "endpointDescription": "digital contact information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1010 S Ponds Dr",
            "city": "Webster",
            "state": "TX",
            "country_code": "US",
            "postal_code": "77598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

Verify at the official NPI Registry.