Jacqueline Grey Witt, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

U3383 Issued in TX

Practice address

27131 Fulshear Bend Dr
Fulshear, TX 77441

Phone

(281) 612-0050

NPI assigned

Mar 20, 2019

Last updated

Apr 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Specialty

Dermatology

Education

Tulane University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elite Dermatology, PLLCGroup PAC ID 8729345285, 26 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwitt@elitedermatology.emadirect.md
• Direct secure messaging: jwitt@tulane.edu

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.

• Elite Dermatology, PLLC

  • Dermatology Physician
  • Katy, TX
  • NPI 1104337526
  Medicare reassignment Care Compare group NPD
• Elite Derm Services, PLLC

  • Dermatopathology (Pathology) Physician
  • Fulshear, TX
  • NPI 1861209298
  NPD
• Hughston Clinic, P.C.

  • Orthopaedic Surgery Physician
  • Columbus, GA
  • NPI 1164461190
  NPD (past)

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1811457567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27131 FULSHEAR BEND DR",
            "city": "FULSHEAR",
            "state": "TX",
            "postal_code": "77441",
            "telephone_number": "281-612-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27131 FULSHEAR BEND DR",
            "city": "FULSHEAR",
            "state": "TX",
            "postal_code": "77441",
            "telephone_number": "281-612-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITT",
        "first_name": "JACQUELINE",
        "middle_name": "GREY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "U3383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwitt@tulane.edu",
            "affiliation": "Y",
            "endpointDescription": "secure education email",
            "affiliationName": "Tulane University Hospital & Clinic",
            "address_1": "1415 Tulane Ave",
            "city": "New Orleans",
            "state": "LA",
            "country_code": "US",
            "postal_code": "701122600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Weeks, FNP-C
• West Houston Healing Services (Nora Mental Health)
• Westside Hospice, Inc
• Kirsten Ann Williams, BCBA, LBA
• Matthew Wiseman, DPT,PT
• Miriam Witwit
• Wordplay Therapy for Pediatrics PLLC
• Yeks Exclusive Homehealth LLC
• Zaau General LLC
• Sabrina Zelaya

• Dermatology Physician in Fulshear, TX
• Providers in Fulshear, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.