Individual provider Active NPI

Jesus Beltran III, M.D.,P.A.

  • Family Medicine Physician
  • Tomball, TX
National Provider Identifier
1811044126
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J6831 Issued in TX
Practice address
11605 Spring Cypress Rd
Unit a
Tomball, TX 77377-8915
Phone
(281) 357-1890
Fax
(281) 351-5032
NPI assigned
Jan 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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 J6831 TX Primary

Addresses

Primary practice location

11605 Spring Cypress Rd
Unit a
Tomball, TX 77377-8915

Mailing address

11605 Spring Cypress Rd
Unit a
Tomball, TX 77377-8915
Phone (281) 357-1890

Other identifiers 3

IdentifierTypeStateIssuer
0063DHOtherTXBCBS PROVIDER NO.
760596382OtherTXTAX ID
135189206MedicaidTX

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
I20100616000650 TX Practitioner - General Practice 0446380521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11605 Spring Cypress Rd
Suite a
Tomball, TX 77377-8915
Phone (281) 357-1890

11605 Spring Cypress Rd a
Tomball, TX 77377-8915

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J6831TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jesus Beltran M D P a Family Medicine CurrentSince Jan 25, 2010 Accepting new patients
Free Foot Doctor.Com Past Accepting new patients
J Moran & Associates Foot & Ankle Clinic PA PastSince Dec 1, 2008 Accepting new patients

Locations

11605 Spring Cypress Rd
Ste A
Tomball, TX 77377
Phone (281) 357-1890

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16376/brand/1/csg/1/fhir/r4

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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1811044126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11605 SPRING CYPRESS RD",
            "address_2": "UNIT A",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773778915",
            "telephone_number": "281-357-1890",
            "fax_number": "281-351-5032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11605 SPRING CYPRESS RD",
            "address_2": "UNIT A",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773778915",
            "telephone_number": "281-357-1890",
            "fax_number": "281-351-5032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELTRAN",
        "first_name": "JESUS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.,P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J6831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NO.",
            "identifier": "0063DH",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "760596382",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135189206",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tomball, TX

Sources for this page

Verify at the official NPI Registry.