Individual provider Active NPI

Jullie A Macasero-Navarro, FNP

  • Nurse Practitioner
  • Laredo, TX
National Provider Identifier
1811244056
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
741655 Issued in TX
Practice address
1515 Pappas St
Laredo, TX 78041-1705
Phone
(956) 795-8100
Fax
(956) 718-6294
NPI assigned
Aug 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 741655 TX Primary

Addresses

Primary practice location

1515 Pappas St
Laredo, TX 78041-1705

Mailing address

1515 Pappas St
Laredo, TX 78041-1705
Phone (956) 795-8100

Other identifiers 2

IdentifierTypeStateIssuer
741655OtherTXLICENSE
312516301MedicaidTX

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130128000403 TX Practitioner - Nurse Practitioner 0446403224 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Community Health Center, Inc. CurrentSince Jun 1, 2020 Accepting new patients
Gateway Community Health Center, Inc. Past Accepting new patients

Locations

1515 Pappas St
Laredo, TX 78041
Phone (956) 523-3642

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1811244056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 PAPPAS ST",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780411705",
            "telephone_number": "956-795-8100",
            "fax_number": "956-718-6294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 PAPPAS ST",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780411705",
            "telephone_number": "956-795-8100",
            "fax_number": "956-718-6294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACASERO-NAVARRO",
        "first_name": "JULLIE",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-07",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "741655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "741655",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "312516301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.