Jack A Teitsma, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

34453 Issued in TX

Practice address

1616 Ponte Leone LN
League City, TX 77573-5067

Phone

(630) 386-5106

NPI assigned

Jun 25, 2009

Last updated

Dec 11, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, MI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Merit-based Incentive Payment System (MIPS)

Final score

91.17 of 100Reported as group

Quality

83.48

Improvement activities

40

Cost

67.52

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Deer Oaks Geriatric Services P C

  dba Deer Oaks Consultation Services

  • Clinical Psychologist
  • San Antonio, TX
  • NPI 1134169287
  Medicare reassignment NPD
• Deer Oaks Minnesota LLC

  • Clinical Psychologist
  • San Antonio, TX
  • NPI 1609158872

  MI

  Medicare reassignment NPD
• Deer Oaks Mental Health Associates PC

  • Clinical Psychologist
  • Las Cruces, NM
  • NPI 1134175763
  NPD (past)

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323561600000",
    "number": "1831327196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 PONTE LEONE LN",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775735067",
            "telephone_number": "630-386-5106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 PONTE LEONE LN",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775735067",
            "telephone_number": "630-386-5106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEITSMA",
        "first_name": "JACK",
        "middle_name": "A",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-25",
        "last_updated": "2011-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "34453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren N Taylor, LVN
• Nicole Taylor, CCC-SLP
• Tamielle Maree Taylor, MA, LPC, LCPC
• Thea M Taylor, DC
• Janice M. Teer, M.D.
• Tejas Anesthesia PLLC
• Meaghan Terminella, APRN
• Texas Kids Behavioral Health (Karen S Roper, PHD)
• The Center for Couples & Families (South Shore Center for Couples & Families)
• The Devereux Foundation (Devereux Texas Treatment Network)

• Clinical Psychologist in League City, TX
• Providers in League City, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2011; 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.